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人工关节置换和人工心脏瓣膜患者泌尿生殖道操作的抗生素预防。

Antibiotic Prophylaxis for Genitourinary Procedures in Patients with Artificial Joint Replacement and Artificial Heart Valves.

机构信息

Department of Urology, George Washington University Hospital, 2150 Pennsylvania Avenue Northwest Suite 3-417, Washington, DC 20037, USA.

Department of Urology, George Washington University Hospital, 2150 Pennsylvania Avenue Northwest Suite 3-417, Washington, DC 20037, USA.

出版信息

Urol Clin North Am. 2024 Nov;51(4):467-474. doi: 10.1016/j.ucl.2024.06.002. Epub 2024 Jul 22.

Abstract

Prosthetic joint infection (PJI) and prosthetic valve endocarditis (PVE) are uncommon but serious complications. According to current best practice statements, prior to a genitourinary procedure, patients with prosthetic joints should receive antibiotic prophylaxis if they are within 2 years of arthroplasty, if they are high risk for infection due to their individual comorbidities, or if the procedure poses a high risk for bacteremia. Patients with prosthetic valves should not receive antibiotic prophylaxis for the sole purpose of prevention of endocarditis. Enterococcus species are the uropathogens most often associated with PJI and PVE. Antibiotic selection should take into account local resistance patterns.

摘要

人工关节感染(PJI)和人工瓣膜心内膜炎(PVE)虽不常见,但后果严重。根据当前最佳实践声明,如果患者在关节置换术后 2 年内、由于个体合并症而有较高的感染风险,或手术有较高的菌血症风险,应在进行泌尿生殖道操作前接受抗生素预防。对于单纯预防心内膜炎,不应给予人工瓣膜患者抗生素预防。肠球菌是与 PJI 和 PVE 最常相关的尿路病原体。抗生素选择应考虑当地耐药模式。

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