伪白假肢关节感染后的结果
Billy I Kim1, Andrew M Schwartz, Colleen M Wixted
1From the Department of Orthopaedic Surgery, Duke University, Durham, NC (Kim, Schwartz, Wixted, Prado, Polascik, and Seyler), and the Division of Infectious Diseases, Duke University, Durham, NC (Dr. Seidelman).
The Journal of the American Academy of Orthopaedic Surgeons
|February 14, 2024
概括
伪虫假肢关节感染 (PJIs) 难以治疗,在多微生物病例中成功率较低. 直接抗微生物工程 (DAIR) 显示出比单微生物PJI的两阶段交换更好的结果.
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:
- 伪omonas物种是假肢关节感染 (PJIs) 中难以治疗的病原体.
- 有限的抗生素选择和生物膜的形成使 Pseudomonas PJI 管理复杂化.
- 这项研究评估了单一机构的结果,并审查了关于Pseudomonas PJIs的现有文献.
研究的目的:
- 评估 Pseudomonas PJIs 在一个机构的治疗结果.
- 为了比较单微生物与多微生物 Pseudomonas PJIs 的结果.
- 审查关于Pseudomonas PJI管理和清除率的当前文献.
主要方法:
- 追溯评估42名患有部或膝盖PJIs的患者,这些患者是由Pseudomonas引起的.
- 治疗后1年感染清除的分析.
- 单独分析单微生物和多微生物感染.
- 专注于Pseudomonas PJI结果的文献综述.
主要成果:
- 一年感染清除率为单微生物PJI的58%,多微生物PJI的35%.
- 对于单微生物PJI,DAIR成功率为63%,而两阶段交换为55%.
- 多微生物感染更常见 (55%),死亡率为44%.
- 在16%的病例中发生了抗伪体抗药性.
结论:
- 伪omonas PJIs,通常是多微生物,很难根除.
- 在文献综述中,DAIR显示了良好的感染清除率 (63-80%).
- 在文献审查中,两阶段的修订显示了可变的清除率 (33-83%).
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