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A Periprosthetic Joint Candida albicans Infection Model in Mouse
Published on: February 2, 2024
Candida prosthetic infections: case series and literature review
Herve Dutronc1, Frédéric A Dauchy, Charles Cazanave
1Service de Maladies Infectieuses et Tropicales, Hôpital Pellegrin, Université Victor Segalen Bordeaux 2, CHU de Bordeaux, Bordeaux, France. herve.dutronc@chu-bordeaux.fr
Abstract:
Candida prosthetic joint infections are considered to be rare. We retrospectively studied patients treated for Candida prosthetic infections between 1 January 1995 and 31 December 2007 in our infectious diseases department, a tertiary referral centre. We identified 7 patients, 4 with knee and 3 with hip prosthetic infections. The most frequent fungal agent was Candida albicans (4 cases), followed by Candida parapsilosis (2 cases) and Candida guillermondii (1 case). All the patients received antifungal treatment for a prolonged period. Five patients had their prosthesis removed and 3 had reimplantation, 1 patient was treated with debridement and prosthetic retention, and the last patient refused surgery. The mean follow-up time was 2.5 y. At the last evaluation, 3 patients were considered as cured, 3 patients presented a secondary bacterial infection leading to amputation for 2 of them, and 1 patient died from heart failure. During Candida prosthetic joint infections, the epidemiological characteristics and the location of the prosthesis are very similar to bacterial prosthetic infections. The benchmark antifungal therapies remain amphotericin B and/or fluconazole.
Insights
Candida prosthetic joint infections, though rare, share similarities with bacterial infections. Treatment often involves prolonged antifungal therapy and surgical intervention, with outcomes varying significantly among patients.
Area of Science:
- Infectious Diseases
- Orthopedics
- Mycology
Background:
- Candida prosthetic joint infections are infrequently encountered.
- This study examines cases of fungal prosthetic joint infections treated at a tertiary referral center.
Observation:
- Seven patients with prosthetic joint infections caused by Candida species were identified between 1995 and 2007.
- Candida albicans was the most common pathogen, followed by Candida parapsilosis and Candida guillermondii.
- Infections affected both knee (4 cases) and hip (3 cases) prostheses.
Findings:
- All patients received extended antifungal treatment.
- Surgical management included prosthesis removal (5 patients), reimplantation (3 patients), or debridement with prosthetic retention (1 patient).
- Outcomes were mixed: 3 patients were cured, 3 developed secondary bacterial infections (leading to amputation in 2), and 1 died from heart failure.
Implications:
- Candida prosthetic joint infections exhibit epidemiological and localization patterns similar to bacterial prosthetic infections.
- Standard antifungal treatments include amphotericin B and/or fluconazole.
- Effective management requires a multidisciplinary approach involving infectious disease specialists and orthopedic surgeons.
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