Prosthetic Joint Infections due to Candida Species: A Multicenter International Study.

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Mycology

Background:

• Prosthetic joint infection (PJI) caused by Candida species is a serious complication following arthroplasty.
• Investigating the outcomes of Candida PJI is crucial for improving patient management.

Purpose of the Study:

• To analyze the treatment outcomes of patients diagnosed with Candida-related PJI.
• To identify factors associated with treatment success or failure in Candida PJI.

Main Methods:

• Retrospective, multinational observational study of patients with Candida PJI from 2010-2021.
• Assessment of treatment outcomes at a 2-year follow-up.
• Analysis of patient demographics, infection sites, surgical procedures, causative Candida species, and antifungal treatments.

Main Results:

• A total of 269 patients were analyzed; 58.0% achieved cure.
• Treatment failure was associated with age >70 years and debridement, antibiotics, and implant retention (DAIR) procedures.
• Candida parapsilosis infection showed a better outcome, while DAIR had lower cure rates compared to 1-stage and 2-stage exchanges.

Conclusions:

• Candida PJI has a generally poor prognosis with a high failure rate.
• Factors like age and surgical strategy significantly influence treatment outcomes.
• Immunosuppression, azole use, and treatment duration did not appear to be linked to failure.