Al Mohajer Mayar, Darouiche Rabih O
1 Department of Medicine, University of Arizona, Tucson, Arizona - USA.
J Appl Biomater Funct Mater. 2014 Jun 12;12(1):1-12. doi: 10.5301/jabfm.5000202.
Prosthetic joint infection (PJI) is a serious and potentially devastating complication of arthroplasty. Prior arthroplasty, immunosuppression, severe comorbid conditions, and prolonged surgical duration are important risk factors for PJI. More than half of the cases of PJI are caused by Staphylococcus aureus and coagulase-negative staphylococci. The biofilm plays a central role in its pathogenesis. The diagnosis of PJI requires the presence of purulence, sinus tract, evidence of inflammation on histopathology, or positive microbiologic cultures. The use of diagnostic imaging techniques is generally limited but may be helpful in selected cases. The most effective way to prevent PJI is to optimize the health of patients, using antibiotic prophylaxis in a proper and timely fashion. Management of PJI frequently requires removal of all hardware and administration of intravenous antibiotics. This review summarizes and analyzes the results of previous reports of PJI and assesses the prevention and management of this important entity.
人工关节感染（PJI）是关节成形术一种严重且可能具有毁灭性的并发症。既往关节成形术、免疫抑制、严重合并症以及手术时间延长是PJI的重要危险因素。超过一半的PJI病例由金黄色葡萄球菌和凝固酶阴性葡萄球菌引起。生物膜在其发病机制中起核心作用。PJI的诊断需要存在脓性分泌物、窦道、组织病理学炎症证据或微生物培养阳性。诊断性成像技术的应用通常有限，但在某些特定病例中可能有所帮助。预防PJI的最有效方法是优化患者健康状况，及时合理地使用抗生素预防。PJI的治疗通常需要取出所有植入物并静脉注射抗生素。本综述总结并分析了先前关于PJI报告的结果，并评估了对这一重要疾病的预防和治疗。
