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Abstract: Introduction: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. Material and methods: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. Results: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients ˂ 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients ˃ 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. Conclusions: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and ˃ 90% without regular scientific production.
Sujets)
Humains , Orthopédie , Procédures orthopédiques , Internat et résidence , Enquêtes et questionnaires , MexiqueRésumé
Resumen: Antecedentes: Los agentes etiológicos más frecuentes en las infecciones periprotésicas son Escherichia coli y Staphylococcus aureus. La frecuencia de estas infecciones se presenta en el reemplazo articular de rodilla de 0.68 a 1.60% en comparación con el de cadera de 0.67 a 2.4%. Objetivo: identificar cuáles son los agentes etiológicos más frecuentes en infecciones periprotésicas en adultos mayores y en pacientes con cirugía primaria de cadera y rodilla. Material y métodos: Se realizó un estudio observacional, transversal y retrospectivo, tipo serie de casos en un período comprendido de Junio de 2011 a Diciembre de 2014, se incluyeron pacientes mayores de 60 años con diagnóstico de infección periprotésica mediante dos cultivos positivos con antibiograma. Resultados: Se evaluaron 62 pacientes, 59.7% presentaron infecciones de rodilla y 40.3% de cadera, 59% fueron infecciones por Escherichia coli y 22% por Staphylococcus aureus. El antibiótico que mejor sensibilidad reportó fue trimetoprim-sulfametoxazol (40.3% )y el de mayor resistencia fue penicilina G (32.2%). Conclusión: Los agentes etiológicos más frecuentes fueron Escherichia coli y Staphylococcus aureus.
Abstract: Background: The most common etiological agents in periprosthetic infections are Escherichia coli and Staphylococcus aureus. The frequency of these infections are found in knee replacement with 0.68 to 1.60% compared to the hip with 0.67 to 2.4%. Objective: To identify what are the most common etiologic agents in periprosthetic infections in elderly patients with primary hip and knee surgery. Material and methods: An observational study, transverse and retrospective case series was performed in a period from June 2011 to December 2014, patients over 60 years with a diagnosis of periprosthetic infection by two positive cultures with antibiograma. Results: 62 patients were evaluated 59.7% were infections of knee and hip 40.3%, 59% were infections by Escherichia coli and Staphylococcus aureus 22%. The best sensitivity reported antibiotic trimethoprim-sulfamethoxazole was 40.3%. The largest penicillin G resistance 32.2%. Conclusion: The most common causative agents were Escherichia coli and Staphylococcus aureus.