Cutibacterium acnes 周围假肢关节感染 关节感染
Christopher N Warne1, Sean Ryan1,2, Elizabeth Yu1,3
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
The bone & joint journal
|November 30, 2024
概括
Cutibacterium acnes 周围假肢关节感染 (PJIs) 经常被遗漏. 这项研究发现,双阶段交换关节整形术和慢性抗生素抑制都显示出C. acnes PJI的良好中期结果.
科学领域:
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
- 微生物学 微生物学
背景情况:
- 由Cutibacterium acnes (C. acnes),以前的Propionibacterium acnes引起的周围假肢关节感染 (PJIs) 越来越多地被认可,但可能没有得到报告.
- 区分真正的C. acnes感染与培养污染对于适当的管理至关重要.
研究的目的:
- 描述由C. acnes引起的部和膝盖PJIs的患者人口统计和治疗结果.
- 评估C. acnes PJIs不同治疗策略的有效性.
主要方法:
- 在2005年至2018年期间对C. acnes PJI患者的回顾性评估.
- 包括标准要求单微生物PJI至少有两个阳性培养;多微生物感染或单个阳性培养被排除在外.
- 分析包括35个病例 (21个部,14个膝盖),平均随访时间为5年.
主要成果:
- 对于C. acnes的阳性培养的中位数时间为五天.
- 常见的实验室标记 (ESR,CRP,突液细胞计数) 与感染一致.
- 治疗包括慢性抗生素抑制 (51%) 或两阶段交换关节塑造;两年无修复生存率为94%.
结论:
- 对C. acnes PJI的实验室发现是典型的,并且培养可能比以前假设的更快.
- 慢性抗生素抑制和双阶段交换关节整形都显示出有利的中期治疗成功率,失败率低.
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