由……引起的二期人工关节感染：基因组测序如何有助于确定最佳治疗策略
Second Periprosthetic Joint Infection Caused by : How Genomic Sequencing Can Help Defining the Best Therapeutic Strategy.
作者信息
Pham Truong-Thanh, Lazarevic Vladimir, Gaia Nadia, Girard Myriam, Cherkaoui Abdessalam, Suva Domizio, Schrenzel Jacques
机构信息
Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.
Division of Orthopedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.
出版信息
Front Med (Lausanne). 2020 Feb 21;7:53. doi: 10.3389/fmed.2020.00053. eCollection 2020.
Abstract
Primary and revision arthroplasties are increasing worldwide, as are periprosthetic joint infections (PJI). The management of PJI requires surgery, the strategy of which is dictated by the acute or chronic nature of the infection, with an exchange of the implant in the event of a chronic PJI or in the case of recurrence with the same pathogen. We report the case of a 63-year-old man with two episodes of subsp. PJI within 9 months. Based on clinical suspicion of an haematogenous PJI, the patient was treated by DAIR (debridement, antibiotics, implant retention), while genomic sequencing revealed two different strains, confirming our hypothesis that no additional surgery was needed. Hence, we report a case where genomic analysis was decisive for the decision of the best therapeutic strategy.
摘要
在全球范围内，初次和翻修关节置换手术的数量在不断增加，假体周围关节感染（PJI）的情况亦是如此。PJI的治疗需要手术，其策略取决于感染的急性或慢性性质，对于慢性PJI或同一病原体复发的情况，需要更换植入物。我们报告了一例63岁男性患者，在9个月内发生了两起亚种PJI。基于血源性PJI的临床怀疑，患者接受了清创、抗生素治疗并保留植入物（DAIR），而基因组测序显示有两种不同的菌株，证实了我们无需额外手术的假设。因此，我们报告了一例基因组分析对最佳治疗策略的决策起决定性作用的病例。
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