Trampuz Andrej, Zimmerli Werner
Division of Infectious diseases and Hospital Epidemiology, University Hospital, Basel, Switzerland.
Swiss Med Wkly. 2005 Apr 30;135(17-18):243-51. doi: 10.4414/smw.2005.10934.
The pathogenesis of prosthetic joint infection is related to microorganisms growing in biofilms, rendering these infections difficult to diagnose and to eradicate. Low-grade infections in particular are difficult to distinguish from aseptic failure, often presenting only with early loosening and persisting pain, or no clinical signs of infection at all. A combination of preoperative and intraoperative tests is usually needed for an accurate diagnosis of infection of prosthetic joint infections. Successful treatment requires adequate surgical procedure combined with long-term antimicrobial therapy, ideally with an agent acting on adhering stationary- phase microorganisms. In this article, epidemiology, pathogenesis, diagnosis and treatment of prosthetic joint infections are reviewed.
人工关节感染的发病机制与生物膜中生长的微生物有关，这使得这些感染难以诊断和根除。特别是低度感染很难与无菌性失败区分开来，通常仅表现为早期松动和持续疼痛，或者根本没有感染的临床体征。人工关节感染的准确诊断通常需要术前和术中检查相结合。成功的治疗需要适当的外科手术结合长期抗菌治疗，理想情况下使用作用于附着的静止期微生物的药物。本文综述了人工关节感染的流行病学、发病机制、诊断和治疗。
