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克林霉素联合治疗对克林霉素敏感、红霉素耐药葡萄球菌属所致骨和关节感染的治疗作用

Clindamycin combination treatment for the treatment of bone and joint infections caused by clindamycin-susceptible, erythromycin-resistant Staphylococcus spp.

作者信息

Bonnaire Agathe, Vernet-Garnier Véronique, Lebrun Delphine, Bajolet Odile, Bonnet Morgane, Hentzien Maxime, Ohl Xavier, Diallo Saidou, Bani-Sadr Firouzé

机构信息

Department of Internal Medicine and Infectious Diseases, Reims Teaching Hospitals, Reims, France.

Department of Bacteriology, Reims Teaching Hospitals, Reims, France.

出版信息

Diagn Microbiol Infect Dis. 2021 Jan;99(1):115225. doi: 10.1016/j.diagmicrobio.2020.115225. Epub 2020 Sep 28.

Abstract

The objective of this study was to evaluate the clinical outcomes and safety of clindamycin combination antibiotherapy for the treatment of erythromycin-resistant, lincosamide-susceptible bone and joint infections caused by Staphylococcus spp. Between January 2010 and September 2018, 46 patients with Staphylococcus spp. erythromycin-resistant, lincosamide-susceptible bone and joint infections were treated with clindamycin combination antibiotherapy for 6 to 12 weeks. The type of infection was prosthetic in 20 cases (43.5%), osteosynthetic device in 15 cases (32.6%), chronic osteomyelitis in 7 cases (15.2%), and arthritis in 4 cases (8.7%). The cure rate was 67.4% by intention to treat and 84.6% per protocol, with a median follow-up of 398 days (range 86-843). Only 2 relapses (5.1%) were observed in patients with chronic osteomyelitis; an acquired resistance to lincosamides developed in 1 case. Clindamycin combination therapy appears to be effective for the treatment of bone and joint infection caused by erythromycin-resistant, lincosamide-susceptible Staphylococcus spp.

摘要

本研究的目的是评估克林霉素联合抗生素疗法治疗由葡萄球菌属引起的对红霉素耐药、对林可酰胺敏感的骨和关节感染的临床疗效和安全性。2010年1月至2018年9月,46例患有对红霉素耐药、对林可酰胺敏感的葡萄球菌属骨和关节感染的患者接受了克林霉素联合抗生素疗法治疗6至12周。感染类型为假体感染20例(43.5%),骨合成装置感染15例(32.6%),慢性骨髓炎7例(15.2%),关节炎4例(8.7%)。意向性治疗的治愈率为67.4%,符合方案分析的治愈率为84.6%,中位随访时间为398天(范围86 - 843天)。慢性骨髓炎患者仅观察到2例复发(5.1%);1例出现对林可酰胺类药物的获得性耐药。克林霉素联合疗法似乎对治疗由对红霉素耐药、对林可酰胺敏感的葡萄球菌属引起的骨和关节感染有效。

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