Interest in the combination of antimicrobial therapy for orthopaedic device-related infections due to Enterococcus spp
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
INTRODUCTION: The objective of this study was to evaluate the management of orthopaedic device-related infections (ODRIs) due to Enterococcus spp.
MATERIALS AND METHODS: We performed a retrospective cohort study in a French tertiary university hospital. Patients with prosthetic joint- or osteosynthesis-associated infections caused by enterococci from 2013 to 2020 were included. Patients who died within 5 days after surgery; who were in palliative care; or who had osteosynthesis of the hand, foot or vertebra were excluded.
RESULTS: Thirty-six patients were included, with 24 in the arthroplasty group and 12 in the osteosynthesis material group. Most infections were polymicrobial (63.9%, n = 23). Debridement, antibiotics and implant retention (DAIR) was performed in 30.6% (n = 11), withdrawal of material in 16.7% (n = 6), one-stage exchange in 30.6% (n = 11) and two-stage exchange in 22.2% of cases (n = 8). The antibiotic regimen was amoxicillin in 41.6% (n = 15), rifampicin in 27.8% (n = 10), linezolid in 25% (n = 9) and/or fluoroquinolones in 30.6% (n = 11). Clinical success at 1 year was 67% (18/27). The only variable statistically associated with a decreased risk of clinical failure was a duration of antibiotic therapy of 12 weeks (p = 0.04). Patients with a lower body mass index and age tended to decrease the risk of clinical failure (p = 0.05 and 0.06 respectively).
CONCLUSIONS: The management of enterococcal ODRIs is complex, and ODRI patients are at high risk for relapse. In our small study, a better outcome was not demonstrated for patients with combination therapy and rifampicin use. Further studies are needed to improve the medico-surgical strategy for treating these infections.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:143 |
|---|---|
| Enthalten in: |
Archives of orthopaedic and trauma surgery - 143(2023), 9 vom: 29. Sept., Seite 5515-5526 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Maurille, Charles [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Bacterial Agents |
|---|
| Anmerkungen: |
Date Completed 28.08.2023 Date Revised 07.11.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00402-023-04848-4 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM354936662 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM354936662 | ||
| 003 | DE-627 | ||
| 005 | 20231226063307.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00402-023-04848-4 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1183.xml |
| 035 | |a (DE-627)NLM354936662 | ||
| 035 | |a (NLM)36988713 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Maurille, Charles |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Interest in the combination of antimicrobial therapy for orthopaedic device-related infections due to Enterococcus spp |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 28.08.2023 | ||
| 500 | |a Date Revised 07.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a INTRODUCTION: The objective of this study was to evaluate the management of orthopaedic device-related infections (ODRIs) due to Enterococcus spp | ||
| 520 | |a MATERIALS AND METHODS: We performed a retrospective cohort study in a French tertiary university hospital. Patients with prosthetic joint- or osteosynthesis-associated infections caused by enterococci from 2013 to 2020 were included. Patients who died within 5 days after surgery; who were in palliative care; or who had osteosynthesis of the hand, foot or vertebra were excluded | ||
| 520 | |a RESULTS: Thirty-six patients were included, with 24 in the arthroplasty group and 12 in the osteosynthesis material group. Most infections were polymicrobial (63.9%, n = 23). Debridement, antibiotics and implant retention (DAIR) was performed in 30.6% (n = 11), withdrawal of material in 16.7% (n = 6), one-stage exchange in 30.6% (n = 11) and two-stage exchange in 22.2% of cases (n = 8). The antibiotic regimen was amoxicillin in 41.6% (n = 15), rifampicin in 27.8% (n = 10), linezolid in 25% (n = 9) and/or fluoroquinolones in 30.6% (n = 11). Clinical success at 1 year was 67% (18/27). The only variable statistically associated with a decreased risk of clinical failure was a duration of antibiotic therapy of 12 weeks (p = 0.04). Patients with a lower body mass index and age tended to decrease the risk of clinical failure (p = 0.05 and 0.06 respectively) | ||
| 520 | |a CONCLUSIONS: The management of enterococcal ODRIs is complex, and ODRI patients are at high risk for relapse. In our small study, a better outcome was not demonstrated for patients with combination therapy and rifampicin use. Further studies are needed to improve the medico-surgical strategy for treating these infections | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Enterococcus faecalis | |
| 650 | 4 | |a Outcome | |
| 650 | 4 | |a Periprosthetic joint infection | |
| 650 | 4 | |a Total hip arthroplasty | |
| 650 | 4 | |a Total knee arthroplasty | |
| 650 | 7 | |a Rifampin |2 NLM | |
| 650 | 7 | |a VJT6J7R4TR |2 NLM | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Michon, Jocelyn |e verfasserin |4 aut | |
| 700 | 1 | |a Isnard, Christophe |e verfasserin |4 aut | |
| 700 | 1 | |a Rochcongar, Goulven |e verfasserin |4 aut | |
| 700 | 1 | |a Verdon, Renaud |e verfasserin |4 aut | |
| 700 | 1 | |a Baldolli, Aurélie |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Archives of orthopaedic and trauma surgery |d 1996 |g 143(2023), 9 vom: 29. Sept., Seite 5515-5526 |w (DE-627)NLM01295120X |x 1434-3916 |7 nnns |
| 773 | 1 | 8 | |g volume:143 |g year:2023 |g number:9 |g day:29 |g month:09 |g pages:5515-5526 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00402-023-04848-4 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 143 |j 2023 |e 9 |b 29 |c 09 |h 5515-5526 | ||