假肢关节感染发生率,病因和结果的变化:冰岛的一项基于人口的研究
Ingunn Haraldsdóttir1, Signy Lea Gunnlaugsdóttir2, Dagur Fridrik Kristjánsson1
1Faculty of Medicine, School of Health Sciences, University of Iceland, 101 Reykjavik, Iceland.
Journal of clinical medicine
|August 14, 2025
概括
整体关节整形术 (TJA) 后的假肢关节感染 (PJIs) 正在增加,特别是在手术后两年内男性中. 虽然治疗成功率有所提高,但更好的预防方法对于PJIs至关重要.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 全关节整形术 (TJA) 的需求增加和假肢关节感染 (PJI) 的增加给患者和医疗保健带来了巨大的负担.
- 这项研究调查了冰岛PJIs的流行病学,临床特征和结果.
- 了解PJI趋势对于改善患者护理和资源配置至关重要.
研究的目的:
- 描述2003年至2020年期间冰岛假肢关节感染 (PJI) 的流行病学,临床特征和结果.
- 为了确定与PJIs相关的风险因素和趋势,全关节整形术 (TJA) 后.
- 评估不同治疗策略的有效性,包括DAIR (削减,抗生素和植入物保留).
主要方法:
- 通过突液培养和ICD代码识别的PJI病例的回顾性分析.
- 根据欧洲骨关节感染学会 (EBJIS) 的标准对PJI病例进行分类.
- 排除不太可能的情况,以确保数据的准确性.
主要成果:
- 总共分析了293个PJI病例,平均年龄为70岁;60%是男性,58%涉及膝盖.
- PJI发病率为0.94%,随着时间的推移显著增加 (p=0.012),男性的发病率更高 (IRR 0.42;p<0.001).
- 最常见的病原体是凝血酶阴性葡萄球菌 (30%);DAIR治疗的失败率接近50%,导致整体38%的治疗失败和2%的PJI相关死亡率.
结论:
- PJI的发病率正在增加,最高风险发生在TJA后的两年内.
- 男性面临PJI的风险更大,尽管女性更频繁地接受TJA.
- 虽然DAIR的成功率低于其他地方,但随着时间的推移,其表现有所改善,这凸显了加强PJI预防策略的必要性.
相关概念视频
01:26Factors Affecting the Risk of Infection
12.3K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
12.3K
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
4.4K
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
4.4K
01:25Endocarditis I: Introduction
26
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
26
01:22Healthcare Associated Infections II: Preventive Measures
2.8K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.8K
01:18Endocarditis III: Medical Management
17
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
17
01:25Endocarditis II: Clinical Features of Infective Endocarditis
25
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
25