OBJECTIVES To systematically evaluate the impact of topical vancomycin powder for microbial profile in spinal surgical site infections. METHODS All available literature regarding the topical use of vancomycin powder to prevent postoperative spinal infections was retrieved from the MEDLINE, EMBASE, and Cochrane databases starting from the creation date and up until September 30, 2018. RESULTS A total of 21 studies involving 15,548 patients were reviewed. The combined odds ratio showed that topical use of vancomycin powder was effective for reducing the incidence of gram-positive bacterial infections in spinal surgical sites (OR 0.41, P < 0.00001) without affecting its efficacy in the prevention of polymicrobial infections (OR 0.30, P = 0.03). Additionally, it could significantly reduce the infection rate of methicillin-resistant staphylococcus (OR 0.34, P < 0.0001). However, topical vancomycin powder showed no advantage for preventing gram-negative bacterial infections (OR 0.94, P = 0.75). CONCLUSIONS Topical administration of vancomycin powder may not increase the rates of gram-negative bacterial or polymicrobial infections in spinal surgical sites. On the contrary, it can significantly reduce the infection rates of gram-positive bacteria, methicillin-resistant staphylococcus (MRS) and microorganism. Of course, the topical vancomycin powder cannot change the rates of gram-negative bacterial infections, which may be related to the antimicrobial spectrum of vancomycin. Due to the limited number of articles included in this study, additional large-scale and high-quality studies are needed to provide more reliable clinical evidence.

中文翻译：

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局部应用万古霉素粉对脊柱外科手术部位感染的微生物谱的荟萃分析。

目的系统评价局部万古霉素粉对脊柱外科手术部位感染中微生物谱的影响。方法从创建日期至2018年9月30日，从MEDLINE，EMBASE和Cochrane数据库中检索有关局部使用万古霉素粉末预防术后脊柱感染的所有可用文献。结果总共进行了21项研究，涉及15,548例患者。已审查。综合比值比显示，局部使用万古霉素粉末可有效减少脊柱外科手术部位革兰氏阳性细菌感染的发生率（OR 0.41，P <0.00001），而不会影响其预防多种微生物感染的功效（OR 0.30，P = 0.03）。另外，可以显着降低耐甲氧西林葡萄球菌的感染率（OR 0.34，P <0.0001）。但是，局部用万古霉素粉末对预防革兰氏阴性细菌感染没有优势（OR 0.94，P = 0.75）。结论局部应用万古霉素粉末可能不会增加脊柱外科手术部位革兰氏阴性细菌或多菌种感染的发生率。相反，它可以显着降低革兰氏阳性细菌，耐甲氧西林的葡萄球菌和微生物的感染率。当然，局部用万古霉素粉末不能改变革兰氏阴性细菌感染的速度，这可能与万古霉素的抗菌谱有关。由于本研究中的文章数量有限，