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2021-01-26

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cc by (c) Gómez Junyent et al., 2021
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/175423

Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study

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https://doi.org/10.3390/antibiotics10020118

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Objectives: To compare the characteristics and outcomes of cases with acute prosthetic joint infection (PJI; early post-surgical or hematogenous) by Staphylococcus aureus managed with implant removal (IRm) or debridement and retention (DAIR). To analyze the outcomes of all cases managed with IRm (initially or after DAIR failure). Methods: Retrospective, multicenter, cohort study of PJI by S. aureus (2003-2010). Overall failure included mortality within 60 days since surgery and local failure due to staphylococcal persistence/relapse. Results: 499 cases, 338 initially managed with DAIR, 161 with IRm. Mortality was higher in acute PJI managed initially with IRm compared to DAIR, but not associated with the surgical procedure, after propensity score matching. Underlying conditions, hemiarthroplasty, and methicillin-resistant S. aureus were risk factors for mortality. Finally, 249 cases underwent IRm (88 after DAIR failure); overall failure was 15.6%. Local failure (9.3%) was slightly higher in cases with several comorbidities, but independent of previous DAIR, type of IRm, and rifampin treatment. Conclusions: In a large multicenter study of S. aureus PJI managed with IRm, failure was low, but mortality significant, especially in cases with acute PJI and underlying conditions, but not associated with the IRm itself. Rifampin efficacy was limited in this setting.

Matèries

Infeccions per estafilococs, Pròtesis, Infeccions quirúrgiques

Matèries (anglès)

Staphylococcal infections, Prosthesis, Surgical wound infection

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

GÓMEZ JUNYENT, Joan, LORA-TAMAYO MORILLO-VELARDE, Jaime, BARAIA ETXABURU, Josu, SÁNCHEZ SOMOLINOS, Mar, IRIBARREN, José a., RODRIGUEZ PARDO, Dolors, PRAENA SEGOVIA, Julia, SORLÍ, Luisa, BAHAMONDE, Alberto, RIERA, Melchor, RICO, Alicia, TORO, Maria dolores del, MORATA, Laura, COBO REINOSO, Javier, FALGUERAS, Luis, BENITO HERNÁNDEZ, M. natividad de, MUÑEZ RUBIO, Elena, JOVER SÁENZ, Alfredo, PIGRAU, Carles, ARIZA CARDENAL, Javier, MURILLO RUBIO, Óscar, GEIO-SEIMC (Bone and Joint Infection Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology), REIPI (Spanish Network for Research in Infectious Diseases). Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study. _Antibiotics_. 2021. Vol. 10, núm. 2. [consulta: 24 de gener de 2026]. [Disponible a: https://hdl.handle.net/2445/175423]

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