Treatment of Joint Prosthesis Infection in Accordance with Current Recommendations Improves Outcome

Betsch, Belinda Y.; Eggli, Stefan; Siebenrock, Klaus A.; Täuber, Martin G.; Mühlemann, Kathrin

doi:10.1086/529436

Cited by 103 publications

(67 citation statements)

References 17 publications

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“…These guidelines have not yet been prospectively validated and were based on only one randomized study, various cohort studies, expert opinion, and animal experiments [1]. However, Betsch et al and Giulieri et al demonstrated the value of current recommendations in cohort studies including patients infected with a broad range of pathogens [3,4]. An inappropriate choice of conservative surgical strategies and inadequate antibiotic treatments were both associated with failure during follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Staphylococci (S. aureus and coagulase-negative staphylococci) are the most frequent causes of implant-associated infections [1][2][3][4][5]. These bacteria have the ability to modify their phenotype in order to persist in vivo.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the Zimmerli algorithm, conservative treatment with implant retention should be reserved for patients with duration of symptoms < 3 weeks, a stable implant, and with intact or slightly damaged soft tissue [1]. Two previous retrospective studies including 60-70 patients presenting with PJI due to a wide range of pathogens, reported that the risk of treatment failure was significantly higher for those treated with a surgical strategy other than that recommended by Zimmerli et al [3,4]. The IDSA guidelines mention a slightly different criterion as conservative treatment with implant retention should be reserved for patients with a duration of symptoms < 3 weeks or a joint age < 30 days, and a stable implant without sinus tract.…”

Section: Introductionmentioning

confidence: 99%

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Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure

Bouaziz

Uçkay

Lustig

et al. 2018

Médecine et Maladies Infectieuses

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Please cite this article in press as: Bouaziz A, et al. Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure. AbstractObjective. -The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known.Patients and methods. -Retrospective (2000-2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure.Results. -Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associated with treatment failure (hazard ratio 2.157; 95% CI [1. 022-4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy, and a rifampicin-based regimen did not significantly influence patient outcome.Conclusion. -Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implant removal is needed to limit treatment failure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure

Bouaziz

Uçkay

Lustig

et al. 2018

Médecine et Maladies Infectieuses

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“…Compliance with these criteria is important, because it significantly improves the chance of cure (Giulieri et al 2004, Betsch et al 2008.…”

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confidence: 99%

Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampin‐based regimen

2008

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“…Betsch ve arkadaşlarının yaptığı çalışmada tek aşamalı ve iki aşamalı deği-şimin başarı oranları %0 (0/4) ve %65 (33/51) olarak bulunurken, Giuleri ve arkadaşlarının yaptı-ğı bir çalışmada ise tek aşamalı değişimin başarı oranı %94 (15/16) iken, iki aşamalı değişimde bu oran %90 (28/31) olarak bulunmuştur [15] .…”

Section: Tablo 4 Operasyon Sonrası Metisiline Dirençliunclassified

Causative Pathogens at Hip and Knee Prosthetic Joint Infections, Treatment Regimens and Evaluation of Prognosis

Ulu¹,

Şele²,

Kuşçu³

et al. 2016

FLORA

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ÖZET GİRİŞHer yıl tüm dünyada bir milyondan fazla kalça protezi yapılmakta ve pek çok insan protez eklemlerle hayatını sürdürmektedir. Gerek travma gerekse de malignite ve artroza bağlı olarak fonksiyonları ileri derecede bozulmuş eklemlerde oldukça başarılı sonuçlar alınmakta ve hastaların hayat kalitesi artmaktadır. Antimikrobiyal profilaksi ve laminar akımlı cerrahi ortamlar intraoperatif infeksiyon riskini azaltmaktadır. Ancak antimikrobiyal tedavilerdeki ve ortopedideki tüm gelişmelere rağmen halen en korkulan komplikasyonlardan biri infeksiyonlardır. İnfeksiyon çoğu kez protezin çıkarılmasına ve eklem fonksiyon kaybına yol açar ve mortalite oranı %2.7-18 arasındadır [1,2] . İnfek-siyon, ortalama hastanede kalış süresini uzatmakta ve hastanın çoğu kez birden fazla ameliyat geçirmesini gerektirmektedir. Uzun süreli antibiyotik tedavisi ve bazen de süpresyon tedavileri nedeniyle de tedavi maliyeti ciddi oranda artmaktadır.Protez infeksiyonlarında konak, yara yeri, ameliyathane ortamı, operatif teknik ve etken mikroorganizmanın özellikleri infeksiyon riski açısından önem taşır. Protez konulan bölgelerin yakınına önceden herhangi bir cerrahi işlem uygulanması, romatoid artrit (RA) ve diabetes mellitus (DM), yetersiz beslenme, ileri yaş ve şişmanlık gibi bazı predispozan faktörler bulunmaktadır [3] . Protez infeksiyonu tanısında altın standart kültürdür. Etkenin izole edilmesi adına uygun ve zamanında örnekleme yapılması önemlidir. Dokunun durumu ve izole edilen patojenin türü ise protez eklem infeksiyonlarının tedavisini şekillendirmektedir.

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Treatment of Joint Prosthesis Infection in Accordance with Current Recommendations Improves Outcome

Abstract: Our study demonstrates the value of current treatment recommendations. Inappropriate choice of conservative surgical strategies (such as debridement and retention) and inadequate antibiotic treatment are associated with failure.

Cited by 103 publications

References 17 publications

Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure

Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure

Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampin‐based regimen

Causative Pathogens at Hip and Knee Prosthetic Joint Infections, Treatment Regimens and Evaluation of Prognosis

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