| Objective To explore the risk factors of deep infection in patients with tibial fracture after operation, and to provide effective basis for clinical prevention. Methods A retrospective study was carried out. Seventy-five patients with tibial fracture diagnosed and developing deep infection after surgical treatment in our hospital from January 2013 to December 2018 were selected as the study group. During the same period, 75 patients with tibial fracture diagnosed and developing no deep infection after surgical treatment were selected as the control group. The risk factors of deep infection were analyzed with univariate and multivariate unconditional Logistic regression analysis. The distribution and drug resistance characteristics of pathogens were investigated. Results Univariate analysis showed that fracture type, osteofascial compartment syndrome and operation time were related with deep infection in the study group (P＜0.05). Multivariate Logistic regression analysis showed that fracture type (OR=4.110, 95%CI: 1.230-8.131), osteofascial compartment syndrome (OR=5.371, 95%CI: 1.696-16.534) and operation time (OR=9.269, 95%CI: 2.619-3.283) were independent risk factors for deep infection in patients with tibial fracture after surgery. A total of 83 pathogenic bacteria were detected, including 36 strains (43.37%) of Gram-negative bacteria and 47 strains (56.63%) of Gram-positive bacteria. The major pathogens were Staphylococcus aureus (31.33%), Escherichia coli (21.69%) and Staphylococcus haemolyticus (20.48%). Escherichia coli had high resistance to cefotaxime, ceftriaxone and chloramphenicol. Pseudomonas aeruginosa had high resistance to cefotaxime, ceftriaxone and clindamycin. Escherichia coli and Pseudomonas aeruginosa were sensitive to imipenem, teicoplanin and linezolid. Staphylococcus aureus was more resistant to ceftriaxone, ampicillin and chloramphenicol. Staphylococcus haemolyticus had the strongest resistance to chloramphenicol. Staphylococcus aureus and Staphylococcus haemolyticus were sensitive to teicoplanin, vancomycin and levofloxacin. Conclusions Through the multivariate regression analysis of deep infection after tibial fracture surgery, fracture type, osteofascial compartment syndrome and operation time are independent risk factors for deep infection after surgical treatment of tibial fracture. For patients with tibial fracture, more attention should be paid to postoperative prophylactic use of antibacterial drugs, based on the drug susceptibility test in this study. Empirical selection of appropriate antibacterial drugs is an important measure to reduce postoperative nosocomial infection. |