本文通过Meta分析明确假体周围感染(periprosthetic joint infection，PJI)的菌群分布情况，探索适用于PJI特定病原菌的用药方案。通过检索PubMed、中国知网、万方医学网以及PubMed等数据库自建库至2022年11月8日的相关文献，纳入PJI病原菌分布及其药敏性的相关文献，收集病原菌分布数据以及其对抗生素的耐药信息，对符合标准的研究采用澳大利亚Joanna Briggs Institute (JBI)循证卫生保健中心对分析性横断面研究的真实性评价标准进行评估，并采用STATA 17软件进行Meta分析。结果显示：共纳入25篇文献，其中22篇为回顾性研究、3篇为随机对照试验。在25项研究中，革兰氏阳性菌的总患病率为76% (95%CI 为[0.72, 0.80]，P<0.01)；革兰氏阴性菌的总患病率为18% (95%CI为 [ 0.15, 0.21]，P<0.01)；真菌的总患病率为3% (95%CI为[ 0.02, 0.04]，P<0.01)；分枝杆菌的总患病率为2% (95%CI为 [0.01, 0.03]，P<0.01)。凝固酶阴性葡萄球菌和金黄色葡萄球菌是导致假体周围感染的2种主要病原菌，临床应探索现有药物更有效的使用方法，以抑制细菌耐药性的发展，同时寻找新的药物作用靶点，为假体周围感染治疗提供更多抗生素选择。

This Meta-analysis aimed to clarify the microbial distribution of periprosthetic joint infection (PJI) and to explore therapeutic strategies for specific pathogens associated with PJI. PubMed, CNKI (China National Knowledge Infrastructure), and Wanfang databases were searched for relevant literature up to November 8, 2022. Studies reporting on the distribution of PJI pathogens and their antimicrobial susceptibility were included. Data on pathogen distribution and antibiotic resistance profiles were collected. Studies meeting the criteria underwent quality assessment used the Joanna Briggs Institute (JBI) critical appraisal tool for analytical cross-sectional studies. Meta-analysis was conducted using STATA 17 software. A total of 25 studies were included, consisting of 22 retrospective studies and 3 randomized controlled trials. Among these 25 studies, the overall prevalence of Gram-positive bacteria was 76% (95% CI is [0.72, 0.80], P<0.01), Gram-negative bacteria was 18% (95% CI is [0.15, 0.21], P<0.01), fungi was 3% (95% CI is [0.02, 0.04], P<0.01), and mycobacteria was 2% (95% CI is [0.01, 0.03], P<0.01). Coagulase-negative Staphylococci and Staphylococcus aureus are the two main pathogens contributing to periprosthetic joint infections. Clinical practice should optimize more effective utilization of existing drugs, mitigate the development of bacterial resistance, and seek new drug targets to expand the range of antibiotic options for periprosthetic joint infections.