格拉姆阴性关节假肢感染:近25%的相同病原体感染持续平均2年
Daniel Karczewski1, Johann Scholz2, Christian Hipfl1
1Department of Orthopaedic Surgery and Traumatology, Charité Berlin, University Hospital, Chariteplatz 1, 10117, Berlin, Germany.
Archives of orthopaedic and trauma surgery
|November 1, 2023
概括
格拉姆阴性周围假肢关节感染 (PJIs) 的复发风险高于格拉姆阳性PJIs. 接受格拉姆阴性PJI修复手术的患者面临着持续感染的显著风险,大约25%的患者出现复发.
科学领域:
- 整形外科手术 整形外科手术
- 传染病 传染病 传染病
- 生物医学工程 生物医学工程
背景情况:
- 周围假肢关节感染 (PJIs) 在骨科手术中带来了重大挑战.
- 格拉姆阴性 (GN) PJIs通常与高的再感染率和困难的治疗有关.
- 中期结果和GN PJIs中的病原体持久性需要进一步调查.
研究的目的:
- 分析 GN PJIs 的人口统计,治疗策略和中期结果.
- 为了比较 GN PJIs 的再感染和复发率与 Gram-positive (GP) PJIs.
主要方法:
- 从大学关节注册表 (2010-2020) 来对30个全关节整形术 (THAs) 中的30个GN PJIs进行了回顾性分析.
- 卡普兰-梅尔对GN PJI的生存率分析.
- 18个国有公用项目和104个公共公用项目 (2013-2017年) 之间的两阶段交流结果的比较.
主要成果:
- 没有复发性PJI的五年生存率为GN PJI的69%.
- 23%的病例在2年内再次感染相同的GN病原体.
- 与GP PJIs相比,GN PJIs的5年生存率明显较低,没有任何感染 (61%vs91%) 和同一病原体的再感染 (73%vs98%).
结论:
- 格拉姆阴性PJIs与格拉姆阳性PJIs相比,再感染和持续的风险要高得多.
- 必须告知GN PJI患者感染复发的高概率以及需要谨慎管理的需要.
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