Widmer A F
Basel University Hospitals, Division of Hospital Epidemiology, Basel, Switzerland.
Clin Infect Dis. 2001 Sep 1;33 Suppl 2:S94-106. doi: 10.1086/321863.
Orthopedic implants have revolutionized treatment of bone fractures and noninfectious joint arthritis. Today, the risk for orthopedic device-related infection (ODRI) is <1%-2%. However, the absolute number of patients with infection continuously increases as the number of patients requiring such implants grows. Treatment of ODRIs most frequently includes long-term antimicrobial treatment and removal of the implant. Recent evidence from observational trials and 1 randomized clinical trial indicate that a subset of patients can be successfully treated with retention of the implant. Patients eligible for such a treatment must meet the following criteria: acute infection defined as signs and symptoms lasting <14-28 days, an unambiguous diagnosis based on histopathology and microbiology, a stable implant, and susceptibility of the microorganism to an effective orally available antimicrobial agent.
骨科植入物彻底改变了骨折和非感染性关节关节炎的治疗方式。如今，骨科器械相关感染（ODRI）的风险低于1%-2%。然而，随着需要此类植入物的患者数量增加，感染患者的绝对数量持续上升。ODRI的治疗通常最常包括长期抗菌治疗和植入物取出。观察性试验和1项随机临床试验的最新证据表明，一部分患者可以通过保留植入物成功治疗。符合这种治疗条件的患者必须满足以下标准：急性感染定义为症状和体征持续时间小于14 - 28天，基于组织病理学和微生物学的明确诊断，植入物稳定，以及微生物对有效的口服抗菌剂敏感。
