関節リウマチ患者の人工関節手術における手術部位感染（ＳＳＩ）サーベイランス

概要

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Objective: The aims of the current study were to examine the incidence of surgical site infections (SSIs) after total joint arthroplasty in patients with rheumatoid arthritis (RA) and to identify risk factors for SSI. Methods: The clinical records of 406 patients with RA who underwent total joint arthroplasty in our hospital between 1999 and 2009 were retrospectively reviewed. The occurrence of SSI in these cases was investigated. The association of SSI with administration of steroids or methotrexate and with the presence of diabetes mellitus were also analyzed.Results: Twelve surgeries were recognized as involving SSI (3.0%), eight with superficial and four with deep infections. Steroid administration showed a statistically significant risk of SSI (P=0.04); however, methotrexate administration showed a lower risk of SSI (P=0.02). After introduction of the guidelines of the Centers for Disease Control and Prevention in 1999, the reported incident rates of SSI were relatively high compared to the previously reported rates. As was found in those studies, our results showed more than half of SSIs occurred as superficial lesions. Conclusion: The rate of SSI in RA patients was 3.0%. More than half of SSIs occurred as superficial lesions. The administration of steroids was one of the risk factors for SSI; however, the administration of methotrexate showed a lower risk of SSI.
日本関節病学会の論文