天津医药

天津医药 ›› 2026, Vol. 54 ›› Issue (4): 379-383.doi: 10.11958/20252915

• 临床研究 • 上一篇    下一篇

下肢闭合性骨折切口感染病原菌分布及miR-15b-5p/IKBKB信号通路相关分子的表达分析

陈素梅1(), 周全2△()   

  1. 1 淮安市第二人民医院感染管理处（邮编223002）
    2 淮安市第二人民医院骨科（邮编223002）
  • 收稿日期:2025-09-15 修回日期:2025-12-04 出版日期:2026-04-15 发布日期:2026-04-14
  • 通讯作者: △E-mail：wuque1@126.com
  • 作者简介:陈素梅（1977），女，副主任护师，主要从事医院感染方面研究。E-mail：wuyou79@sina.cn
  • 基金资助:
    江苏省卫生健康委科研项目(M2022125)

Distribution of pathogenic bacteria in incisional infections of closed lower limb fracture and expression analysis of miR-15b-5p/IKBKB signaling pathway-related molecules

CHEN Sumei1(), ZHOU Quan2△()   

  1. 1 Department of Infection Control, the Second People’s Hospital of Huai’an City, Huai’an 223002, China
    2 Department of Orthopedics, the Second People’s Hospital of Huai’an City, Huai’an 223002, China
  • Received:2025-09-15 Revised:2025-12-04 Published:2026-04-15 Online:2026-04-14
  • Contact: △E-mail：wuque1@126.com

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摘要：

目的 探讨下肢闭合性骨折术后切口感染的病原菌分布和不同病原菌对微小RNA-15b-5p（miR-15b-5p）/B细胞κ轻肽基因增强子抑制因子激酶β（IKBKB）信号通路相关分子表达的影响。方法 分析了2 318例下肢闭合性骨折患者术后切口感染情况，并根据其中确诊切口感染的120例患者的病原菌分为耐甲氧西林金黄色葡萄球菌（MRSA）组（A组）、甲氧西林敏感性金黄色葡萄球菌（MSSA）组（B组）、凝固酶阴性葡萄球菌（CNS）组（C组）和其他细菌组（D组），分析各组病原菌对常用抗生素的敏感性。收集感染切口组织标本，采用qRT-PCR及Western blot检测miR-15b-5p、IKBKB mRNA和蛋白的表达，分析各组间miR-15b-5p、IKBKB的表达情况。结果 本组患者切口感染率为5.18%，120例感染患者中金黄色葡萄球菌感染84例（70.00%）；各组内病原菌对头孢唑林钠和头孢呋辛钠的敏感性差异均无统计学意义（P>0.05），不同组间病原菌对头孢唑林钠和头孢呋辛钠的敏感性差异均有统计学意义（P<0.01），与A组相比，B组、C组、D组对头孢唑啉钠和头孢呋辛钠的敏感性差异有统计学意义（均P<0.01），与B组相比，C组、D组对头孢唑啉钠和头孢呋辛钠的敏感性差异均有统计学意义（均P<0.01）。C组、D组miR-15b-5p的表达低于A组、B组（P<0.01）；C组、D组IKBKB mRNA和蛋白的表达高于A组、B组（P<0.01）。结论 金黄色葡萄球菌是引起下肢闭合性骨折术后切口感染最常见细菌，金黄色葡萄球菌可诱导组织中miR-15b-5p的表达增高，并可能通过调控IKBKB的表达促进炎症进展。

关键词: 骨折, 闭合性, 金黄色葡萄球菌, 微生物敏感性试验, 微RNAs, I-κB蛋白质类, 切口感染

Abstract:

Objective To investigate the distribution of pathogenic bacteria in postoperative incision infection following closed lower limb fracture and the effects of different pathogens on the expression of microRNA-15b-5p (miR-15b-5p)/inhibitor of nuclear factor kappa-B kinase subunit beta (IKBKB) signaling pathway-related molecules. Methods A total of 2 318 patients with closed lower limb fracture were analyzed for postoperative incision infection, with 120 patients diagnosed with incision infection. These patients were divided into the methicillin-resistant Staphylococcus aureus (MRSA) group (group A), the methicillin-sensitive S. aureus (MSSA) group (group B), the coagulase-negative staphylococci (CNS) group (group C) and the other bacterial groups (group D) based on the pathogens. The sensitivity of these pathogens to commonly used antibiotics in each group was analyzed. Infected incision tissue specimens were collected, and the expression levels of miR-15b-5p, IKBKB mRNA and protein were detected using qRT-PCR and Western blot assay to analyze the expression differences between the groups. Results The incidence of incision infection in this group was 5.18%. Among the 120 infected patients, Staphylococcus aureus infection was identified in 84 cases (70.00%). There were no statistically significant differences in the sensitivity of the pathogens to cefazolin sodium and cefuroxime sodium between the groups (P > 0.05). There were significant differences in the sensitivity differences of pathogens to cefazolin sodium, cefuroxime sodium and cefuroxime sodium between different groups (P < 0.01). Compared to the group A, the differences in the sensitivity to cefazolin sodium and cefuroxime sodium were statistically significant in the groups B, C and D (P < 0.01). Compared to the group B, the differences in the sensitivity to cefazolin sodium and cefuroxime sodium were also statistically significant in the groups C and D (P < 0.01). The expression levels of miR-15b-5p were lower in the group C and the group D than those of the group A and the group B (P < 0.01). The expression levels of IKBKB mRNA and protein were higher in the group C and the group D than those in the group A and the group B (P < 0.01). Conclusion Staphylococcus aureus is the most common bacterium causing postoperative incision infections following closed lower limb fracture. It can induce the increased expression of miR-15b-5p in tissue and may promote inflammatory progression by regulating the expression of IKBKB.

Key words: fractures, closed, staphylococcus aureus, microbial sensitivity tests, microRNAs, I-kappa B proteins, surgical site infection

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