摘要/Abstract
摘要： 目的· 探究骨科创伤后伤口感染（post-traumatic wound infection，PWI）和手术部位感染（surgery site infection，SSI）的季节
性变化以及各自的微生物分布情况。方法· 对上海交通大学附属第六人民医院骨科2013—2015 年的2 177 例四肢开放性创伤患者及
11 809 例择期手术患者的数据进行统计，分析各季节中PWI 和SSI 的发生率。通过多元线性回归分析PWI 发生率和气象学参数的相关
性，统计并分析PWI 和SSI 的微生物季节性分布。结果· 2013—2015 年上述患者PWI 发生率为2.20%，且具有季节差异性，夏、秋
季高，冬、春季低（P=0.004）；SSI 发生率为0.21%，未发现季节差异性（P=0.809）。多元线性回归分析中，气温与PWI 发生率相关
（P=0.002，β=0.016）。在微生物季节性分布的研究中，SSI 夏秋季以革兰阴性菌为主（P=0.021），PWI 中分离培养的微生物无季节性分
布差异（P=0.694）。结论· PWI 存在季节性差异，夏、秋季发生率高，与气温具有相关性；SSI 发生率未发现季节性差异，但SSI 在微
生物季节分布中存在差异，夏秋季以革兰阴性菌感染为主。
关键词: 创伤后伤口感染, 手术部位感染, 季节, 气温, 革兰阴性菌
Abstract:
Objective · To examine the seasonality of post-traumatic wound infection (PWI) and surgery site infection (SSI) from the perspectives of
occurrence and microbiological distribution. Methods · The cumulative incidences of PWI and SSI in different seasons were respectively calculated
and compared in a cohort of 2 177 patients who sustained open-wounded injuries in the upper or lower extremity and a cohort of 11 809 patients
receiving selective orthopedic operation from 2013 to 2015 in Shanghai Sixth People’s Hospital. Multifactorial linear regression was used to measure the
influence of meteorological parameters on PWI incidence. Moreover, the microbiological distribution of PWI and SSI was analyzed on a seasonal basis.
Results · The incidence of PWI in the patients was 2.20% from 2013 to 2015, and there were significant seasonal patterns (1.04% in spring, 3.52% in
summer, 3.10% in autumn, 0.71% in winter, P=0.004). The incidence of SSI was 0.21%, and there was no seasonal difference (P=0.809). Only average
temperature (P=0.002, β=0.016) was correlated with the occurrence of PWI in multifactorial linear regression analysis. Microbiological analysis revealed
the dominance of Gram-negative bacteria in SSI cases during the summer and autumn (P=0.021). However, this trend was not observed in PWI cases
(P=0.694). Conclusion · There is a seasonal pattern in PWI occurrence with peaks in summer and autumn, which is correlated with temperature. There is
no seasonal difference in SSI incidence, but SSI cases were dominantly infected by Gram-negative bacteria in summer and autumn.
Key words: post-traumatic wound infection, surgery site infection, season, temperature, gram-negative bacteria
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