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Research goal. To determine the spectrum of pathogens in the synovial fluid and their resistance to antimicrobial drugs. Research objectives: 1. To determine the spectrum of pathogens in synovial fluid. 2. To evaluate the resistance of microorganisms to antimicrobials drugs. 3. To compare the spectra of pathogens in the synovial fluids of the hip and knee joints. 4. To evaluate the duration of development of prosthetic joint infection depending on the causative pathogens. Research materials and methods. Given the permission from the Bioethics Center of Lithuanian University of Health Sciences, a retrospective study of cases of patients who underwent microbiological analysis of synovial fluid cultures and were treated in Kaunas Clinics of the Hospital of Lithuanian University of Health Sciences during the year 2016 was performed. Data from medical documentation and results of microbiological tests were analyzed. Statistical analysis was done using “SPSS Windows 22.0”, “Microsoft Office Excel 2016” programs. Qualitative attribute distribution independence was checked using the Chi-square criterium (χ²). The data was held statistically relevant, when the difference between groups was defined if the significance plane is p ≤ 0,05. Results. 306 patiens were examined: 164 women and 142 men who underwent synovial fluid cultures and 97 of which were positive. The spectrum of the bacteria that grew in the joint liquid culture samples were: 45 % S.aureus, 27 % S.epidermidis, 17 % Enterobacteriales family bacteria, 6,2 % P.aeruginosa and 5,2 % S.agalactiae. After determining the resistance of microorganisms to antibiotics, it was established, that the strain of S.aureus was sensitive to methicillin, however the strain of S.epidermidis was resistant to methicillin. S. agalactiae and P. aeruginosa had the biggest sensitivity to the tested antibiotics. Enterobacteriales family bacteria were the most sensitive to meropenem and the most resistance to ampicillin. Samples of the synovial fluid of knee and hip joints were the largest share of examined cultures and made up 51,55 % and 27,84 % respectively. After comparing the spectrum of bacteria in the knee and hip joints it was determined, that S.aureus and S.epidermidis bacteria had distributed unevenly (p ≤ 0.05). The most cases of infection in prosthetic joints were reported during the period of time from one to three years after the endoprosthesis procedure (p ≤ 0.05). Research conclusions: 1. S.aureus was the most common pathogen in synovial fluid samples, S.epidermidis was the second most common and other pathogens made up less than 10 percent. 2. In most of the cases pathogen S.aureus was sensitive to methicillin whereas the second most common pathogen S. epidermidis was resistant to methicillin. 3. A statistically significant difference between the pathogens in the synovial fluid of the knee and hip joints was determined: the most common pathogen in the samples of synovial fluid from the knee joint was S.aureus and in samples from the hip joint it was S. epidermidis. 4. The largest share of infection after a prosthesis surgery cases occurred during the period from one to three years after the procedure compared to the periods of time from three to six years and less than one year. A difference in the spectrum of pathogens was not determined. |
