Ridberg Sara, Hellmark Bengt, Nilsdotter Åsa, Söderquist Bo
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Infectious Diseases and Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden.
J Bone Jt Infect. 2019 Apr 20;4(3):106-110. doi: 10.7150/jbji.30954. eCollection 2019.
The frequency of prosthetic joint infections (PJIs) due to (formerly ) is increasing, especially shoulder PJIs. The recommended antibiotic prophylaxis for hip and knee arthroplasties is beta-lactam antibiotics, predominantly cephalosporins. However, for example in Sweden, isoxazolyl-penicillin cloxacillin is used. No specific recommendations for shoulder arthroplasties are available. The aim of the present study was to determine the minimum inhibitory concentration (MIC) values for different antibiotics for ; and, more specifically, to compare the MIC values for benzylpenicillin and oxacillin. Minimum inhibitory concentration (MIC) values for nine different antibiotic agents were obtained by gradient test (Etest) using strains of (n= 57) isolated from PJIs from shoulders (n=31), hips (n=21), and knees (n=5). All isolates had low MIC values for most of the tested antibiotic agents, and showed a wild type MIC distribution. The exception was clindamycin with 9% of the isolates displaying decreased susceptibility. The MIC values obtained for benzylpenicillin were significantly lower than the MIC values for isoxazolyl-penicillin (oxacillin). These results indicate that benzylpenicillin might be a more effective prophylactic treatment to prevent shoulder PJIs caused by . However, further studies on the subject are needed, and the effectiveness of the prophylactic treatment should be evaluated using randomized controlled studies and/or register-based studies.
由(以前为)引起的人工关节感染(PJI)的频率正在增加,尤其是肩关节PJI。髋关节和膝关节置换术推荐的抗生素预防用药是β-内酰胺类抗生素,主要是头孢菌素。然而,例如在瑞典,使用的是异恶唑基青霉素氯唑西林。对于肩关节置换术尚无具体推荐。本研究的目的是确定不同抗生素对的最低抑菌浓度(MIC)值;更具体地说,是比较苄青霉素和苯唑西林的MIC值。通过梯度试验(Etest),使用从肩关节(n = 31)、髋关节(n = 21)和膝关节(n = 5)的PJI中分离出的(n = 57)菌株,获得了九种不同抗生素的最低抑菌浓度(MIC)值。所有分离株对大多数测试抗生素的MIC值都较低,并呈现野生型MIC分布。例外的是克林霉素,9%的分离株显示敏感性降低。苄青霉素获得的MIC值显著低于异恶唑基青霉素(苯唑西林)的MIC值。这些结果表明,苄青霉素可能是预防由引起的肩关节PJI更有效的预防性治疗方法。然而,需要对该主题进行进一步研究,并且应使用随机对照研究和/或基于登记的研究来评估预防性治疗的有效性。