Service de Médecine Interne, Vasculaire et Pneumologie, Hôpital La Cavale Blanche, CHRU Brest, Brest, France.
Infectious Diseases and Intensive Care Unit, CHU Rennes, Rennes, France.
Infection. 2021 Feb;49(1):127-133. doi: 10.1007/s15010-020-01551-z. Epub 2021 Jan 2.
Prosthetic vascular graft infection (PVGI) is a very severe disease. We aimed to determine the factors associated with treatment failure.
Patients admitted to two University Hospitals with PVGI were included in this retrospective study. PVGI was classified as possible, probable or proven according to an original set of diagnostic criteria. We defined treatment failure if one of the following events occurred within the first year after PVGI diagnosis: death and infection recurrence due to the same or another pathogen.
One hundred and twelve patients were diagnosed with possible (n = 26), probable (n = 22) and proven (n = 64) PVGI. Bacterial documentation was obtained for 81% of patients. The most frequently identified pathogen was Staphylococcus aureus (n = 39). Surgery was performed in 96 patients (86%). Antibiotics were administered for more than 6 weeks in 41% of patients. Treatment failure occurred in 30 patients (27.5%). The factors associated with a lower probability of treatment failure were total removal of the infected graft (OR = 0.2, 95% CI [0.1-0.6]), rifampicin administration (OR = 0.3 [0.1-0.9]) and possible PVGI according to the GRIP criteria (OR = 0.3 [0.1-0.9]).
Treatment failure occurred in 27.5% of patients with PVGI. Total removal of the infected graft and rifampicin administration were associated with better outcomes.
人造血管移植物感染（PVGI）是一种非常严重的疾病。我们旨在确定与治疗失败相关的因素。
本回顾性研究纳入了两所大学医院收治的 PVGI 患者。根据一套原始诊断标准，将 PVGI 分为可能、可能和确诊。如果在 PVGI 诊断后 1 年内发生以下事件之一，则定义为治疗失败：死亡和因同一或其他病原体引起的感染复发。
112 例患者被诊断为可能（n=26）、可能（n=22）和确诊（n=64）PVGI。81%的患者获得了细菌学资料。最常鉴定的病原体是金黄色葡萄球菌（n=39）。96 例患者（86%）接受了手术。41%的患者接受了超过 6 周的抗生素治疗。30 例患者（27.5%）发生治疗失败。与治疗失败概率较低相关的因素包括：感染移植物的完全切除（OR=0.2，95%CI[0.1-0.6]）、利福平治疗（OR=0.3[0.1-0.9]）和根据 GRIP 标准的可能 PVGI（OR=0.3[0.1-0.9]）。
PVGI 患者中有 27.5%发生治疗失败。完全切除感染移植物和利福平治疗与更好的结局相关。
