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与其他革兰氏阴性杆菌引起的急性人工关节感染患者的临床结局比较。

Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by Compared to Other Gram-Negative Bacilli.

作者信息

Liu Wai-Yan, Hendriks Johannes G E, van Kempen Robin W T M, van der Weegen Walter, Rijnen Wim H C, Goosen Jon H M, van der Zwaard Babette C, Pronk Yvette, Zijlstra Wierd P, Ten Have Bas L E F, Ploegmakers Joris J W, Wouthuyzen-Bakker Marjan

机构信息

Department of Orthopaedic Surgery & Trauma, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands.

Department of Orthopaedic Surgery & Trauma, Máxima MC, 5631 BM Eindhoven, The Netherlands.

出版信息

Microorganisms. 2025 Apr 14;13(4):904. doi: 10.3390/microorganisms13040904.

Abstract

is considered as more difficult to treat than other Gram-negatives in patients with acute periprosthetic joint infections (PJIs). However, clinical data to support this hypothesis are lacking. This retrospective multicenter cohort study included 39 patients with acute PJIs caused by and 84 control patients with another Gram-negative bacillus (i.e., Enterobacterales). Both groups were managed by surgical debridement, antibiotics, and implant retention (DAIR). Treatment failure within one-year follow-up was defined as prosthesis extraction, a clinical need for suppressive antibiotic treatment and/or PJI-related death. Distribution of affected joints, and revision versus primary arthroplasties, did not differ between groups. Most PJIs were polymicrobial (87% in cases, 81% in control patients, = 0.451). Surgical and antibiotic management was similar between groups. Treatment failure did not differ between groups: 5/39 cases (12.8%) and 14/84 control patients (16.7%, = 0.610). An acceptable success rate of acute PJI caused by when treated with DAIR was observed. This success rate did not differ compared to PJIs caused by Enterobacterales. Therefore, should not be considered a more difficult to treat microorganism compared to other Gram-negatives. No additional surgical or antimicrobial interventions are needed when patients can be treated with a fluoroquinolone.

摘要

在急性人工关节周围感染(PJI)患者中,[具体细菌名称未给出]被认为比其他革兰氏阴性菌更难治疗。然而,缺乏支持这一假设的临床数据。这项回顾性多中心队列研究纳入了39例由[具体细菌名称未给出]引起的急性PJI患者和84例由另一种革兰氏阴性杆菌(即肠杆菌科细菌)引起感染的对照患者。两组患者均接受手术清创、抗生素治疗和保留植入物(DAIR)。一年随访期内的治疗失败定义为假体取出、临床需要进行抑制性抗生素治疗和/或与PJI相关的死亡。两组在受影响关节的分布以及翻修手术与初次置换手术方面没有差异。大多数PJI是多微生物感染(病例组为87%,对照组为81%,P = 0.451)。两组之间的手术和抗生素治疗管理相似。两组之间的治疗失败情况没有差异:5/39例(12.8%)病例组和14/84例(16.7%)对照组患者(P = 0.610)。观察到采用DAIR治疗由[具体细菌名称未给出]引起的急性PJI有可接受的成功率。与由肠杆菌科细菌引起的PJI相比,该成功率没有差异。因此,与其他革兰氏阴性菌相比,[具体细菌名称未给出]不应被视为更难治疗的微生物。当患者可以使用氟喹诺酮类药物治疗时,不需要额外的手术或抗菌干预措施。

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