Analysis of pathogenic bacteria and risk factors for postoperative infection in patients with diabetes undergoing orthopedic surgery

OBJECTIVE To investigate the pathogenic bacteria causing postoperative infection in patients with diabetes undergoing orthopedic surgery and analyze the risk factors for such postoperative infections.

METHODS A total of 140 patients with diabetes who underwent orthopedic surgery at the Second Affiliated Hospital of Guangxi Medical University from Jan. 2023 to Dec. 2024 were selected. Based on postoperative infection status, they were divided into an infection group (n=24) and a non-infection group (n=116). The two groups were compared in terms of gender, age, body mass index, blood glucose levels, operation time, surgical approach, incision length and other indicators. Logistic regression analysis was performed to explore the risk factors for postoperative infection in patients with diabetes undergoing orthopedic surgery. Additionally, the infected strains and levels of inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were measured.

RESULTS Among the 140 patients, 24 cases developed postoperative infections, with an incidence rate of 17.14% (24/140). The majority of infections occurred at the incision site (45.83%). The levels of IL-6, TNF-α and CRP in the infection group were (2.71±0.43) ng/ml, (9.71±1.58) ng/ml and (11.62±1.35) mg/L, respectively, significantly higher than those in the non-infection group (P < 0.05). HbA1c level (OR=5.987) and incision type (OR=9.356) were identified as risk factors for postoperative infection in patients with diabetes undergoing orthopedic surgery (P < 0.05). A total of 31 pathogenic bacteria were isolated from specimens of infected patients, including 21 gram-positive bacteria (67.74%) and 9 gram-negative bacteria (29.03%), with Staphylococcus aureus and Staphylococcus epidermidis being the main pathogenic bacteria.

CONCLUSIONS The postoperative infection rate is high among patients with diabetes undergoing orthopedic surgery. Risk factors include HbA1c level and incision type, with Staphylococcus aureus and Staphylococcus epidermidis being the main pathogenic bacteria.