Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention
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Citações na Scopus
14
Tipo de produção
article
Data de publicação
2020
Título da Revista
ISSN da Revista
Título do Volume
Editora
BMC
Citação
BMC MUSCULOSKELETAL DISORDERS, v.21, n.1, article ID 574, 6p, 2020
Resumo
Background Evaluate the effect of bacteria drug resistance profile on the success rates of debridement, antibiotics and implant retention. Methods All early acute periprosthetic infections in hip and knee arthroplasties treated with DAIR at our institution over the period from 2011 to 2015 were retrospectively analyzed. The success rate was evaluated according to the type of organism identified in culture: multidrug-sensitive (MSB), methicillin-resistantStaphylococcus aureus(MRSA), multidrug-resistant Gram-negative bacteria (MRB) and according to other risk factors for treatment failure. The data were analyzed using univariate and multivariate statistics. Results Fifty-seven patients were analyzed; there were 37 in the multidrug-sensitive bacteria (MSB) group, 11 in the methicillin-resistantStaphylococcus aureus(MRSA) group and 9 in the other multidrug-resistant Gram-negative bacteria (MRB) group. There was a statistically significant difference (p < 0.05) in the treatment failure rate among the three groups: 8.3% for the MSB group, 18.2% for the MRSA group and 55.6% for the MRB group (p = 0.005). Among the other risk factors for treatment failure, the presence of inflammatory arthritis presented a failure rate of 45.1 (p < 0.05). Conclusion DAIR showed a good success rate in cases of early acute infection by multidrug-sensitive bacteria. In the presence of infection by multidrug-resistant bacteria or association with rheumatic diseases the treatment failure rate was higher and other surgical options should be considered in this specific population. The MRSA group showed intermediate results between MSB and MRB and should be carefully evaluated.
Palavras-chave
Periprosthetic joint infection, Total hip arthroplasty, Total knee arthroplasty, Multidrug resistant bacteria, Complications, Acute post-operative infection, DAIR (debridement, Antibiotics and implant retention)
Referências
- Bene N, 2018, KNEE, V25, P932, DOI 10.1016/j.knee.2018.07.003
- Bongartz T, 2008, ARTHRIT RHEUM-ARTHR, V59, P1713, DOI 10.1002/art.24060
- Bozhkova S, 2016, J ORTHOP TRAUMATOL, V17, P369, DOI 10.1007/s10195-016-0417-8
- Bozic KJ, 2012, J BONE JOINT SURG AM, V94A, P794, DOI 10.2106/JBJS.K.00072
- Bozic KJ, 2009, J BONE JOINT SURG AM, V91A, P128, DOI 10.2106/JBJS.H.00155
- Bradbury T, 2009, J ARTHROPLASTY, V24, P101, DOI 10.1016/j.arth.2009.04.028
- Cochran AR, 2016, J ARTHROPLASTY, V31, pS156, DOI 10.1016/j.arth.2016.03.028
- Crockarell JR, 1998, J BONE JOINT SURG AM, V80A, P1306, DOI 10.2106/00004623-199809000-00009
- Gottfriedsen TB, 2016, J BONE JOINT SURG AM, V98, P1962, DOI 10.2106/JBJS.15.01362
- Hsieh PH, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0071666
- Hsieh PH, 2009, CLIN INFECT DIS, V49, P1036, DOI 10.1086/605593
- Karachalios T, 2014, HIP INT, V24, pS44, DOI 10.5301/hipint.5000166
- Khan LAK, 2009, HIP INT, V19, P47
- Koyonos L, 2011, CLIN ORTHOP RELAT R, V469, P3043, DOI 10.1007/s11999-011-1910-2
- Kurtz S, 2007, J BONE JOINT SURG AM, V89A, P780, DOI 10.2106/JBJS.F.00222
- Kurtz SM, 2008, J ARTHROPLASTY, V23, P984, DOI 10.1016/j.arth.2007.10.017
- Lima Ana Lucia Lei Munhoz, 2010, Rev. bras. ortop., V45, P520, DOI [10.1590/S0102-36162010000600002, 10.1016/S2255-4971(15)30296-2]
- Malinzak RA, 2009, J ARTHROPLASTY, V24, P84, DOI 10.1016/j.arth.2009.05.016
- Odum SM, 2011, J ARTHROPLASTY, V26, P114, DOI 10.1016/j.arth.2011.03.031
- Parvizi J, 2011, CLIN ORTHOP RELAT R, V469, P3022, DOI 10.1007/s11999-011-1971-2
- Siljander MP, 2018, J ARTHROPLASTY, V33, P185, DOI 10.1016/j.arth.2017.07.045
- Vasso M, 2016, KNEE SURG SPORT TR A, V24, P3140, DOI 10.1007/s00167-016-4010-8
- Zimmerli W, 2004, NEW ENGL J MED, V351, P1645, DOI 10.1056/NEJMra040181
- Zmistowski B, 2011, J ARTHROPLASTY, V26, P104, DOI 10.1016/j.arth.2011.03.044