假肢关节感染的Candida结果预测:系统性审查和元分析
Charles Gibert1,2, Camille Marchetti1,3, Benoît Guery3
1Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Open forum infectious diseases
|June 4, 2025
概括
在Candida假肢关节感染 (CPJI) 中,完全去除硬件至关重要. 首次使用B氨酸的治疗改善了结果,而同时感染金黄色葡萄球菌和保留假肢则预测了失败.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
背景情况:
- 坎迪达假肢关节感染 (CPJI) 是严重的并发症,没有明确的最佳管理策略.
- 对CPJI的外科干预和抗真菌治疗需要进一步澄清.
- 预测CPJI的结果对于改善患者护理至关重要.
研究的目的:
- 系统地审查和对CPJI现有的文献进行元分析.
- 在CPJI中确定治疗成功和失败的预测因素.
- 为CPJI管理提供基于证据的建议.
主要方法:
- 在2024年7月之前,对PubMed,Medline,Embase和Web of Science的系统文献审查.
- 包括来自队列,病例系列和成人CPJI病例报告的个体患者数据.
- 单变量和多变量逻辑回归分析以确定结果预测因素.
主要成果:
- 分析了来自110个出版物的385个CPJI病例,其中33%是多微生物病例.
- 最常见的物种是Candida albicans (47.2%) 和Candida parapsilosis (28.6%).它们是最常见的物种.
- 失败的独立预测因素:黄金葡萄球菌的同时感染和假肢保留. 成功的预测因素:一线安二B疗法.
结论:
- 完整的硬件移除对于成功的CPJI管理至关重要.
- 安福特里辛B证明了作为CPJI的初始抗真菌疗法的有效性.
- 假肢保留和S. aureus联合感染与CPJI中较差的结果有关.
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