Prosthetic Shoulder Joint Infection by Cutibacterium acnes: Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study
Por:
Vilchez, HH, Escudero-Sanchez, R, Fernandez-Sampedro, M, Murillo, O, Aunon, A, Rodriguez-Pardo, D, Jover-Saenz, A, del Toro, MD, Rico, A, Falgueras, L, Praena-Segovia, J, Guio, L, Iribarren, JA, Lora-Tamayo, J, Benito, N, Morata, L, Ramirez, A, Riera, M, Mur, I, Coll P., Crusi X., Soriano, A.
Publicada:
1 may 2021
Resumen:
This retrospective, multicenter observational study aimed to describe the outcomes of surgical and medical treatment of C. acnes-related prosthetic joint infection (PJI) and the potential benefit of rifampin-based therapies. Patients with C. acnes-related PJI who were diagnosed and treated between January 2003 and December 2016 were included. We analyzed 44 patients with C. acnes-related PJI (median age, 67.5 years (IQR, 57.3-75.8)); 75% were men. The majority (61.4%) had late chronic infection according to the Tsukayama classification. All patients received surgical treatment, and most antibiotic regimens (43.2%) included beta-lactam. Thirty-four patients (87.17%) were cured; five showed relapse. The final outcome (cure vs. relapse) showed a nonsignificant trend toward higher failure frequency among patients with previous prosthesis (OR: 6.89; 95% CI: 0.80-58.90) or prior surgery and infection (OR: 10.67; 95% IC: 1.08-105.28) in the same joint. Patients treated with clindamycin alone had a higher recurrence rate (40.0% vs. 8.8%). Rifampin treatment did not decrease recurrence in patients treated with beta-lactams. Prior prosthesis, surgery, or infection in the same joint might be related to recurrence, and rifampin-based combinations do not seem to improve prognosis. Debridement and implant retention appear a safe option for surgical treatment of early PJI.
Filiaciones:
Vilchez, HH:
Hosp Univ Son Espases, Infect Dis Unit, Dept Internal Med, Fundacio Inst Invest Sanitaria Illes Balea IdISBa, Palma De Mallorca 07120, Spain
Escudero-Sanchez, R:
Hosp Univ Ramon y Cajal, Dept Infect Dis, Madrid 28034, Spain
Fernandez-Sampedro, M:
Hosp Univ Marques de Valdecilla IDIVAL, Dept Med, Infect Dis Unit, Cantabria 39008, Spain
Murillo, O:
Hosp Univ Bellvitge, Dept Infect Dis, Barcelona 08907, Spain
Aunon, A:
IIS Fdn Jimenez Diaz, Dept Orthopaed Surg, Bone & Joint Infect Unit, Madrid 28040, Spain
Rodriguez-Pardo, D:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Infect Dis, Barcelona 08035, Spain
Jover-Saenz, A:
Hosp Arnau Vilanova, Unit Nosocomial Infect, Lleida 25198, Spain
del Toro, MD:
Univ Seville, Clin Unit Infect Dis Microbiol & Prevent Med, Hosp Univ Virgen Macarena CSIC, Inst Biomed Sevilla IBiS, Seville 41009, Spain
Rico, A:
Hosp Univ La Paz, Infect Dis Unit & Clin Microbiol, Madrid 28046, Spain
Falgueras, L:
Corp Sanitaria Parc Tauli, Dept Infect Dis, Barcelona 08208, Spain
Praena-Segovia, J:
Univ Hosp Virgen del Rocio, Clin Unit Infect Dis Microbiol & Prevent Med, Seville 41013, Spain
Guio, L:
Hosp Univ Cruces, Dept Infect Dis, Vizcaya 48903, Spain
Iribarren, JA:
Hosp Univ Donostia, Inst BioDonostia, Dept Infect Dis, San Sebastian 20014, Spain
Lora-Tamayo, J:
Hosp Univ 12 Octubre, Infect Dis Unit, Dept Internal Med, Inst Invest Hosp 12 Octubre I 12, Madrid 28041, Spain
Benito, N:
Univ Autonoma Barcelona, Infect Dis Unit, Hosp Santa Creu & St Pau, Inst Invest Biomed St Pau,Dept Med, Barcelona 08041, Spain
Morata, L:
Univ Barcelona, Dept Infect Dis, Hosp Clin Barcelona, IDIBAPS, Barcelona 08036, Spain
Ramirez, A:
Hosp Univ Son Espases, Dept Microbiol, Palma De Mallorca 07120, Spain
Riera, M:
Hosp Univ Son Espases, Infect Dis Unit, Dept Internal Med, Fundacio Inst Invest Sanitaria Illes Balea IdISBa, Palma De Mallorca 07120, Spain
Mur, I:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Coll P.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Crusi X.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Soriano, A.:
Univ Barcelona, Dept Infect Dis, Hosp Clin Barcelona, IDIBAPS, Barcelona 08036, Spain
gold, Green Published
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