真菌性人工肩关节周围感染:一项系统评价

Fungal Shoulder Periprosthetic Infections: A Systematic Review.

作者信息

Giovanoulis Vasileios, Pastamentzas Vasileios, Veizi Enejd, Matzaroglou Charalampos, Naoum Symeon, Samonis George, Piagkou Maria, Papadopoulos Dimitrios V, Tsantes Andreas G, Koutserimpas Christos

机构信息

Department of Orthopaedic Surgery, Hôpital Henri Mondor, AP-HP, Université Paris Est Créteil (UPEC), 94010 Creteil, France.

Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, 11525 Athina, Greece.

出版信息

J Clin Med. 2024 Oct 14;13(20):6128. doi: 10.3390/jcm13206128.

Abstract

: Data regarding fungal PJIs of the shoulder are scarce. The present systematic review aims to identify and evaluate all published shoulder fungal PJIs in an effort to better understand the diagnostic and therapeutic approach to these infections. : A systematic review according to the PRISMA guidelines was conducted, locating all shoulder fungal PJIs. The initial search located 1435 articles. Data were collected on demographics, the causative fungus, antifungal treatment (AFT), surgical interventions, and infection outcomes. After screening and implementation of the inclusion criteria, a total of 10 articles, including 10 cases, were eligible. The sample's mean age was 62.44 years. Diabetes mellitus was the most common comorbidity (30%), while 70% were immunocompromised. spp. was the most common causative fungus (nine cases; 90%), while all cases were confirmed with cultures. In three cases (30%), there was bacterial co-infection. The mean duration of antifungal treatment (AFT) was 8.4 weeks, while the preferred agent was fluconazole (60% of cases), followed by amphotericin B (30%). Most cases (50%) underwent resection arthroplasty as part of the treatment, while two-stage revision arthroplasty was performed in 30%. Infection's eradication was reported in 90% of the studied cases. : The diagnosis and management of fungal periprosthetic shoulder infections are particularly challenging and require a multidisciplinary approach. The combination of antifungal therapy and tailored surgical strategies is crucial, but further research is needed to refine treatment protocols and address the unique considerations in shoulder PJIs.

摘要

关于肩部真菌性假体周围感染(PJI)的数据稀缺。本系统评价旨在识别和评估所有已发表的肩部真菌性PJI,以便更好地了解这些感染的诊断和治疗方法。

根据PRISMA指南进行了系统评价,查找所有肩部真菌性PJI。初步检索找到1435篇文章。收集了有关人口统计学、致病真菌、抗真菌治疗(AFT)、手术干预和感染结果的数据。在筛选并实施纳入标准后,共有10篇文章符合条件,包括10个病例。样本的平均年龄为62.44岁。糖尿病是最常见的合并症(30%),而70%的患者存在免疫功能低下。 属是最常见的致病真菌(9例;90%),所有病例均通过培养确诊。3例(30%)存在细菌合并感染。抗真菌治疗(AFT)的平均持续时间为8.4周,首选药物是氟康唑(60%的病例),其次是两性霉素B(30%)。大多数病例(50%)接受了切除关节成形术作为治疗的一部分,而30%的病例进行了两阶段翻修关节成形术。90%的研究病例报告感染得到根除。

肩部真菌性假体周围感染的诊断和管理特别具有挑战性,需要多学科方法。抗真菌治疗与量身定制的手术策略相结合至关重要,但需要进一步研究以完善治疗方案并解决肩部PJI中的独特考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f487/11508564/d7eb6764c65b/jcm-13-06128-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索