Institute of Microbiology, Lille University Hospital, 59037, Lille, France.
Orthopaedic Department, Lille University Hospital, 59037, Lille, France.
Ann Clin Microbiol Antimicrob. 2020 Mar 21;19(1):9. doi: 10.1186/s12941-020-00351-5.
This study aimed to evaluate in vitro susceptibility to ceftobiprole of clinical strains identified from prosthetic joint infections (PJIs) compared to that of the associations currently recommended for post-operative empirical antibiotic therapy (PEAT) (vancomycin with either cefepime, third-generation cephalosporin or piperacillin-tazobactam).
We performed a 1-year retrospective study on all the surgical procedures performed in our hospital for PJI. Susceptibility profiles of all the strains cultured from surgical samples were reviewed to compare ceftobiprole to current used associations.
During the study period (from January 2018 to December 2018), we identified 106 patients managed for PJI and a total of 216 surgical interventions. One hundred-fifty strains were identified from intraoperative samples, excluding redundant strains. Staphylococcus spp. represented 52.7% of all strains and Enterobacteriales 13.3%. Twenty-three patients had polymicrobial infection (22%). Among 149 surgical procedures with positive culture results, ceftobiprole covered the bacterial strains in 138 (92.6%) cases. In comparison, this percentage was 94.6% for vancomycin plus cefepime (p = 0.64), 92.6% for vancomycin plus a third-generation cephalosporin in 138 cases (p = 1) and 94.6% for vancomycin plus piperacillin-tazobactam) (p = 0.64).
Based on antimicrobial susceptibility testing, our results suggest that ceftobiprole could be an interesting option for PEAT in PJIs, allowing the use of a single agent.
本研究旨在评估从人工关节感染（PJI）中分离出的临床菌株对头孢托罗的体外药敏情况，与目前推荐的术后经验性抗生素治疗（PEAT）的联合用药（万古霉素联合头孢吡肟、第三代头孢菌素或哌拉西林他唑巴坦）进行比较。
我们对我院所有因 PJI 而行手术治疗的患者进行了为期 1 年的回顾性研究。对从手术样本中培养出的所有菌株的药敏谱进行评估，以比较头孢托罗与目前使用的联合用药。
在研究期间（2018 年 1 月至 2018 年 12 月），我们共发现 106 例 PJI 患者，共进行了 216 次手术干预。从术中样本中鉴定出 150 株菌，排除了冗余菌株。葡萄球菌属占所有菌株的 52.7%，肠杆菌科占 13.3%。23 例患者发生混合感染（22%）。在 149 例培养阳性的手术中，头孢托罗覆盖了 138 例（92.6%）的细菌菌株。相比之下，万古霉素联合头孢吡肟的覆盖率为 94.6%（p=0.64），万古霉素联合 138 例第三代头孢菌素的覆盖率为 92.6%（p=1），万古霉素联合哌拉西林他唑巴坦的覆盖率为 94.6%（p=0.64）。
根据抗菌药物敏感性试验结果，我们的研究结果表明，头孢托罗可能是 PJI 患者术后经验性抗生素治疗的一种有吸引力的选择，可以使用单一药物。
