Objective To investigate the characteristics of pathogens and influencing factors of surgical site infections (SSI) in patients with thoracolumbar fractures after surgery. Methods A total of 1500 patients with thoracolumbar fractures who underwent internal fixation at Nanchong Hospital of Traditional Chinese Medicine from February 2022 to February 2025 were studied. Patients were divided into non - infection (n=1476) and infection (n=24) groups. Pathogen cultures from SSI patients were analyzed, and clinical data were collected for univariate and multivariate logistic regression analyses. Results Among the 24 patients with SSIs, a total of 28 pathogens were isolated, including 11 Gram-positive bacteria, 16 Gram-negative bacteria, and 1 fungus. The resistance rates of Staphylococcus aureus to amoxicillin, ampicillin, and penicillin were 60.00%, 60.00%, and 80.00%, respectively. The resistance rates of Staphylococcus epidermidis to amoxicillin, ampicillin, and penicillin were 50.00%, 50.00%, and 75.00%, respectively. Escherichia coli exhibited high resistance rates to amoxicillin, ampicillin, piperacillin, and gentamicin, at 50.00%, 66.67%, 83.33%, and 50.00%, respectively. Pseudomonas aeruginosa showed high resistance to co-trimoxazole, amoxicillin, ampicillin, and piperacillin, with resistance rates of 60.00%, 60.00%, 60.00%, and 80.00%, respectively. The infection group had a higher proportion of patients with surgical segments>3, intraoperative blood loss>400 mL, and postoperative drainage tube placement>3 days than the non - infection group. Albumin (ALB) levels were lower in the infection group. Surgical segments, intraoperative blood loss, and postoperative drainage time were positively correlated with SSIs, while ALB levels were negatively correlated. Multivariate analysis revealed intraoperative blood loss, postoperative drainage time, and ALB levels as independent risk factors for SSIs, with intraoperative blood loss showing good predictive value (AUC=0.765>0.700). Conclusion In patients with thoracolumbar fractures, Gram-negative bacteria account for a slightly higher proportion of surgical site infections. Intraoperative blood loss, postoperative drainage time, and ALB levels are independent risk factors for SSIs. Intraoperative blood loss has good predictive value and can serve as a potential biomarker for the early diagnosis of SSI.
Key words
thoracolumbar fractures /
surgery /
infection /
pathogens /
risk factors
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