Dutronc Herve, Dauchy Frédéric A, Cazanave Charles, Rougie Catherine, Lafarie-Castet Sabine, Couprie Bernard, Fabre Thierry, Dupon Michel
Service de Maladies Infectieuses et Tropicales, Hôpital Pellegrin, Université Victor Segalen Bordeaux 2, CHU de Bordeaux, Bordeaux, France.
Scand J Infect Dis. 2010 Dec;42(11-12):890-5. doi: 10.3109/00365548.2010.498023. Epub 2010 Jul 7.
Candida prosthetic joint infections are considered to be rare. We retrospectively studied patients treated for Candida prosthetic infections between 1 January 1995 and 31 December 2007 in our infectious diseases department, a tertiary referral centre. We identified 7 patients, 4 with knee and 3 with hip prosthetic infections. The most frequent fungal agent was Candida albicans (4 cases), followed by Candida parapsilosis (2 cases) and Candida guillermondii (1 case). All the patients received antifungal treatment for a prolonged period. Five patients had their prosthesis removed and 3 had reimplantation, 1 patient was treated with debridement and prosthetic retention, and the last patient refused surgery. The mean follow-up time was 2.5 y. At the last evaluation, 3 patients were considered as cured, 3 patients presented a secondary bacterial infection leading to amputation for 2 of them, and 1 patient died from heart failure. During Candida prosthetic joint infections, the epidemiological characteristics and the location of the prosthesis are very similar to bacterial prosthetic infections. The benchmark antifungal therapies remain amphotericin B and/or fluconazole.
假丝酵母菌人工关节感染被认为较为罕见。我们对1995年1月1日至2007年12月31日期间在我们传染病科（一家三级转诊中心）接受假丝酵母菌人工关节感染治疗的患者进行了回顾性研究。我们确定了7例患者，其中4例为膝关节人工关节感染，3例为髋关节人工关节感染。最常见的真菌病原体是白色假丝酵母菌（4例），其次是近平滑假丝酵母菌（2例）和季也蒙假丝酵母菌（1例）。所有患者均接受了长时间的抗真菌治疗。5例患者的假体被移除，3例进行了再植入，1例患者接受了清创和保留假体治疗，最后1例患者拒绝手术。平均随访时间为2.5年。在最后一次评估时，3例患者被认为已治愈，3例患者出现继发性细菌感染，其中2例导致截肢，1例患者死于心力衰竭。在假丝酵母菌人工关节感染期间，流行病学特征和假体位置与细菌性人工关节感染非常相似。标准的抗真菌治疗仍然是两性霉素B和/或氟康唑。
