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Title: | Rates and Predictors of Treatment Failure in Staphylococcus aureus Prosthetic Joint Infections According to Different Management Strategies: A Multinational Cohort Study—The ARTHR-IS Study Group |
Author: | Espíndola, Reinaldo Vella, Venanzio Benito, Natividad Mur, Isabel Tedeschi, Sara Zamparini, Eleonora Hendriks, Johannes G. E. Sorlí, Luisa Murillo, Oscar Soldevila, Laura Scarborough, Mathew Scarborough, Claire Kluytmans, Jan Ferrari, Mateo Carlo Pletz, Mathias W. Mcnamara, Iain Escudero-sanchez, Rosa Arvieux, Cedric Batailler, Cecile Dauchy, Frédéric Antoine Liu, Wai Yan Lora Tamayo, Jaime Praena, Julia Ustianowski, Andrew Cinconze, Elisa Pellegrini, Michele Bagnoli, Fabio Rodríguez-baño, Jesús Toro, Maria Dolores del Cuperus, Nienke Manfré, Giuseppe Suárez Barrenechea, Ana Isabel Pascual Hernandez, Alvaro Rivera, Alba Crusi, Xavier Jordán, Marcos Rossi, Nicolò Vande Kerkhof, Tessa Horcajada, Juan P. Gómez Junyent, Joan Alier, Albert Rijen, Miranda van Romme, Jannie Ankert, Juliane Whitehouse, Celia Jones, Adrian Cobo, Javier Moreno, Javier Meheut, Anne Gledel, Claire Perreau, Pauline Wensen, Remco J. A. Van Lindergard, Gabriella ARTHR-IS Group |
Keywords: | Infeccions per estafilococs Articulacions artificials Staphylococcal infections Artificial joints |
Issue Date: | 15-Oct-2022 |
Publisher: | Springer Science and Business Media LLC |
Abstract: | Introduction: Guidelines have improved the management of prosthetic joint infections (PJI). However, it is necessary to reassess the incidence and risk factors for treatment failure (TF) of Staphylococcus aureus PJI (SA-PJI) including functional loss, which has so far been neglected as an outcome. Methods: A retrospective cohort study of SA-PJI was performed in 19 European hospitals between 2014 and 2016. The outcome variable was TF, including related mortality, clinical failure and functional loss both after the initial surgical procedure and after all procedures at 18 months. Predictors of TF were identified by logistic regression. Landmark analysis was used to avoid immortal time bias with rifampicin when debridement, antibiotics and implant retention (DAIR) was performed. Results: One hundred twenty cases of SA-PJI were included. TF rates after the first and all surgical procedures performed were 32.8% and 24.2%, respectively. After all procedures, functional loss was 6.0% for DAIR and 17.2% for prosthesis removal. Variables independently associated with TF for the first procedure were Charlson >= 2, haemoglobin < 10 g/dL, bacteraemia, polymicrobial infection and additional debridement(s). For DAIR, TF was also associated with a body mass index (BMI) > 30 kg/m(2) and delay of DAIR, while rifampicin use was protective. For all procedures, the variables associated with TF were haemoglobin < 10 g/dL, hip fracture and additional joint surgery not related to persistent infection. Conclusions: TF remains common in SA-PJI. Functional loss accounted for a substantial proportion of treatment failures, particularly after prosthesis removal. Use of rifampicin after DAIR was associated with a protective effect. Among the risk factors identified, anaemia and obesity have not frequently been reported in previous studies. [GRAPHICS] . |
Note: | Reproducció del document publicat a: https://doi.org/10.1007/s40121-022-00701-0 |
It is part of: | Infectious Diseases and Therapy, 2022, vol. 11, num. 6, p. 2177-2203 |
URI: | http://hdl.handle.net/2445/205247 |
Related resource: | https://doi.org/10.1007/s40121-022-00701-0 |
ISSN: | 2193-6382 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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