当植入物被更换时,我们是否应该在由葡萄球菌引起的周围假肢关节感染中使用利法素? 一个多中心的观察队列研究

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Tobias Siegfried Kramer^1,2,3, Alex Soriano⁴, Sarah Tedeschi^5,6

¹Institute for Hygiene and Environmental Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.

Open forum infectious diseases

|October 30, 2023

概括

利芬素改善了经历两阶段交换手术的慢性葡萄球菌周围假肢关节感染 (PJI) 的结果. 这种组合治疗,加上长时间的抗生素假期,在这些复杂的病例中显著降低了治疗失败率.

科学领域:

整形外科整形外科整形外科
传染性疾病传染性疾病
药理学药理学是指药理学的学科.

背景情况:

葡萄球菌周围假肢关节感染 (PJIs) 是关节置换手术的一个重要并发症.
基于利芬素的疗法在经过除菌治疗的急性PJI中已显示出有效性,但对植入物交换的证据有限.

研究的目的:

评估瑞芬素在经过修复手术治疗的葡萄球菌PJIs中的疗效,特别关注植入物交换.
在这些具有挑战性的病例中确定临床成功的预测因素.

主要方法:

国际,回顾性,多中心观察队列研究,对375名接受修复手术的葡萄球菌PJIs患者进行了回顾性观察队列研究 (2013年1月至2018年12月).
基于欧洲骨关节感染学会标准的PJI诊断.
临床失败定义为复发,再感染,需要抑制性治疗,切除植入物或与PJI相关的死亡.

主要成果:

整体而言,里芬素和非里芬素组之间的失败率没有显著差异 (22.5%和31.4%).
在经过两阶段交换治疗的慢性PJI中,利芬素使用与明显较低的失败率 (15%对35.5%,P = .005) 相联系.
利芬素使用和超过2周的抗生素假期是2阶段交换子组成功的独立预测因素.

结论:

与利芬素的联合治疗增强了在经历两阶段交换关节整形手术的慢性葡萄球菌PJI患者的治疗成功率.
在这些情况下,延长抗生素假期对于成功的结果至关重要.

关键词:

在PJI PJI中.周围假肢关节感染这种药物是里法皮辛 (rifampicin).这就是为什么Rifampin是Rifampin.葡萄糖球菌 (Staphylococci) 是一种葡萄糖球菌.

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