宿主和微生物特征与复发的假肢关节感染相关
Jessica P Hampton1,2, Joanne Y Zhou1, Floriane Ngako Kameni2
1Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California, USA.
概括
抗生素隔离器后复发的假肢关节感染与严重的系统性损害和多微生物感染等宿主因素有关,而不是细菌耐药性. 黄金葡萄球菌也是重复感染的关键指标.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 假肢关节感染 (PJI) 是关节整形术后的一个重大并发症.
- 大约20%的PJI双阶段复查患者经历了复发性感染.
- 了解预测复发性PJI的因素对于改善治疗结果至关重要.
研究的目的:
- 为了确定宿主和细菌特征与复发性假肢关节感染 (PJI) 相关的两个阶段修订关节塑造术后.
- 为了比较患者人口统计,宿主等级和单次和复发PJI患者之间的微生物学数据.
主要方法:
- 一项对2009年至2020年期间为PJI治疗的106名患者的病例控制研究.
- 患者被分为单个PJI (一个间隔器) 和复发PJI (≥2间隔器) 组.
- 患者人口统计数据,麦克菲尔森宿主等级和手术内培养结果的比较,包括抗生素敏感性.
主要成果:
- 复发性PJI患者患多微生物感染的几率高11倍,严重系统性损害的几率增加一倍 (麦克菲森宿主C级).
- 黄金葡萄球菌在复发性PJI病例中更为普遍.
- 两组之间没有观察到病原体对常见抗生素耐药性的显著差异.
结论:
- 麦克菲尔森宿主等级,多微生物感染和金黄色葡萄球菌是复发性PJI的关键指标.
- 在这些情况下,细菌对抗生素的耐药性似乎并不能预测治疗失败.
- 对宿主-病原体相互作用的进一步研究是有必要的,以优化复杂PJI的管理策略.
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