Becker A, Triffault-Fillit C, Valour F, Boussel L, Ruffion A, Laurent F, Senneville E, Chidiac C, Ferry T
Service des maladies infectieuses et tropicales, CRIOAc Lyon, hospices civils de Lyon, 69004 Lyon, France.
Service des maladies infectieuses et tropicales, CRIOAc Lyon, hospices civils de Lyon, 69004 Lyon, France.
Med Mal Infect. 2020 Nov;50(8):684-688. doi: 10.1016/j.medmal.2019.10.012. Epub 2019 Nov 18.
To describe the epidemiology of pubic osteomyelitis (PO) and to look for factors associated with treatment failure.
Retrospective study describing PO according to outcome: success or failure of initial management. Factors associated with failure determined by univariate Cox analysis. Kaplan-Meier curve compared between groups by log-rank test.
Twenty-five patients were included over a 13-year period; 24% of PO had blood-borne infection. Failure (44%) was always observed in chronic postoperative presentations (76%). Fistula (32%) was only observed in postoperative presentations and was significantly associated with failure (HR 5.1; P=0.011). Other risk factors were pelvic malignant tumor history, abscess, infection due to extended-spectrum beta-lactamase-producing Enterobacteriaceae, and polymicrobial infection.
PO is most often a chronic postoperative polymicrobial infection in patients with comorbidities at high risk of relapse. Studies in larger cohorts could assess the efficacy of more aggressive surgical strategies in patients at high risk of failure.
描述耻骨骨髓炎（PO）的流行病学特征，并寻找与治疗失败相关的因素。
回顾性研究，根据初始治疗结局（成功或失败）描述PO。通过单因素Cox分析确定与失败相关的因素。采用对数秩检验比较各组间的Kaplan-Meier曲线。
在13年期间纳入了25例患者；24%的PO有血行感染。失败（44%）总是出现在慢性术后表现（76%）中。瘘管（32%）仅在术后表现中观察到，且与失败显著相关（风险比5.1；P=0.011）。其他危险因素包括盆腔恶性肿瘤病史、脓肿、产超广谱β-内酰胺酶肠杆菌科细菌引起的感染以及混合感染。
PO通常是合并症患者术后的慢性混合感染，复发风险高。更大队列的研究可以评估更积极的手术策略对高失败风险患者的疗效。
