Predictors of failure for prosthetic joint infections treated with debridement

被引：16
作者：
Letouvet, B. [1 ]
Arvieux, C. [2 ,3 ]
Leroy, H. [2 ,3 ]
Polard, J. -L. [3 ,4 ]
Chapplain, J. -M. [2 ,3 ]
Common, H. [3 ,4 ]
Ecoffey, C. [1 ]
Huten, D. [3 ,4 ]
Jolivet-Gougeon, A. [3 ,5 ]
Tattevin, P. [2 ,3 ]
机构：
[1] Univ Rennes 1, Hop Pontchaillou, Reanimat Chirurg & Anesthesie, Rue Le Guilloux, F-35033 Rennes, France
[2] Univ Rennes 1, Hop Pontchaillou, Serv Malad Infect & Reanimat Med, CHU Pontchaillou, Rue Le Guilloux, F-35033 Rennes, France
[3] Univ Rennes 1, Hop Pontchaillou, CRIOAC, Rue Le Guilloux, F-35033 Rennes, France
[4] Univ Rennes 1, Hop Pontchaillou, Orthoped Traumatol, Rue Le Guilloux, F-35033 Rennes, France
[5] Univ Rennes 1, Hop Pontchaillou, Dept Bacteriol & Hyg Hosp, Rue Le Guilloux, F-35033 Rennes, France
来源：
MEDECINE ET MALADIES INFECTIEUSES | 2016年 / 46卷 / 01期
关键词：
Prosthetic joint infection; Staphylococcus aureus; Debridement; TOTAL KNEE ARTHROPLASTY; IRRIGATION; RETENTION; HIP;
D O I：
10.1016/j.medmal.2015.11.007
中图分类号：
R51 [传染病];
学科分类号：
100401 ;
摘要：
Objective. - Prosthetic joint infections (PJI) may be cured in selected patients with debridement and prosthesis retention. We aimed to identify predictors of failure to better target patients most likely to benefit from this conservative strategy. Methods. - Observational study of patients presenting with PJI initially treated at our hospital with debridement between 2008 and 2011, with >6 months of post-treatment follow-up. Results. - Sixty consecutive patients presenting with PH (hip, n = 34; knee, n = 26) fulfilled the inclusion criteria. Failures (n = 20, 33%), predefined as persistence of PJI signs or relapses, were managed with additional surgery (n = 17) and/or lifelong suppressive antibiotic treatment (n = 6). Variables independently associated with failure: previous surgery on the prosthetic joint (OR: 6.3 [1.8-22.3]), Staphylococcus aureus PH (OR: 9.4 [1.6-53.9]), post-debridement antibiotic treatment for <3 months (OR: 20.0 [2.2-200]). Conclusion. Previous surgery, S. aureus PJI, and short duration antibiotic treatment are associated with an increased risk of failure after debridement. (C) 2015 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码：39 / 43
页数：5
相关论文
共 15 条
  • [1] Management of infections of osteoarticular prosthesis
    Barberán, J
    [J]. CLINICAL MICROBIOLOGY AND INFECTION, 2006, 12 : 93 - 101
  • [2] The Preoperative Prediction of Success Following Irrigation and Debridement With Polyethylene Exchange for Hip and Knee Prosthetic Joint Infections
    Buller, Leonard T.
    Sabry, Fady Youssef
    Easton, Robert W.
    Klika, Alison K.
    Barsoum, Wael K.
    [J]. JOURNAL OF ARTHROPLASTY, 2012, 27 (06) : 857 - 864
  • [3] Infection Associated with Prosthetic Joints
    Del Pozo, Jose L.
    Patel, Robin
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2009, 361 (08) : 787 - 794
  • [4] Infection After Primary Total Hip Arthroplasty
    Lindeque, Bennie
    Hartman, Zach
    Noshchenko, Andriy
    Cruse, Margaret
    [J]. ORTHOPEDICS, 2014, 37 (04) : 257 - +
  • [5] Outcome of prosthetic joint infections treated with debridement and retention of components
    Marculescu, CE
    Berbari, EF
    Hanssen, AD
    Steckelberg, JM
    Harmsen, SW
    Mandrekar, JN
    Osmon, DR
    [J]. CLINICAL INFECTIOUS DISEASES, 2006, 42 (04) : 471 - 478
  • [6] Guiding empirical antibiotic therapy in orthopaedics: The microbiology of prosthetic joint infection managed by debridement, irrigation and prosthesis retention
    Moran, E.
    Masters, S.
    Berendt, A. R.
    McLardy-Smith, P.
    Byren, I.
    Atkins, B. L.
    [J]. JOURNAL OF INFECTION, 2007, 55 (01) : 1 - 7
  • [7] Osmon DR, 2013, CLIN INFECT DIS, V56, P1, DOI [10.1093/cid/cis966, 10.1093/cid/cis803]
  • [8] Acute haematogenous prosthetic joint infection: prospective evaluation of medical and surgical management
    Rodriguez, D.
    Pigrau, C.
    Euba, G.
    Cobo, J.
    Garcia-Lechuz, J.
    Palomino, J.
    Riera, M.
    del Toro, M. D.
    Granados, A.
    Ariza, X.
    [J]. CLINICAL MICROBIOLOGY AND INFECTION, 2010, 16 (12) : 1789 - 1795
  • [9] TREATMENT OF INFECTION AFTER TOTAL KNEE ARTHROPLASTY BY DEBRIDEMENT WITH RETENTION OF THE COMPONENTS
    SCHOIFET, SD
    MORREY, BF
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1990, 72A (09) : 1383 - 1390
  • [10] Infection after total knee arthroplasty - A retrospective study of the treatment of eighty-one infections
    Segawa, H
    Tsukayama, DT
    Kyle, RF
    Becker, DA
    Gustilo, RB
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1999, 81A (10) : 1434 - 1445
12