蛋白质与物种相关的关节和膝关节周围假肢感染 - 一个15年的队列分析
Veronika Achatz1,1, Jennyfer A Mitterer1,2,1,2, Stephanie Huber1,3,1,3
1Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Speising, Vienna, Austria.
Journal of bone and joint infection
|August 14, 2025
概括
蛋白质物种是周围假肢关节感染 (PJIs) 的罕见原因,通常发生在慢性,多微生物病例中,特别是在部修订中. 尽管整体失败率很高,但西普洛克萨显示出有前途的治疗疗效.
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:
- 周围假肢关节感染 (PJIs) 是关节整形手术的严重并发症.
- 格拉姆阴性细菌与不良的PJI结果有关.
- 有限的数据存在于Proteus物种作为PJIs的致病原体.
研究的目的:
- 调查与Proteus物种相关的PJIs的流行率和特征.
- 分析这些感染的临床结果,抗菌药物治疗和手术程序.
- 确定与Proteus PJIs相关的风险因素和成功率.
主要方法:
- 从2008年到2024年,对1776个培养阳性修订关节和膝关节关节置换术 (rTHA和rTKA) 的回顾性评估.
- 使用欧洲骨关节感染学会和国际共识会议标准进行分类.
- 统计分析包括千二测试和二进制后勤回归用于风险因素和结果.
主要成果:
- 蛋白种占PJI的1.5% (26例),主要是慢性 (65.4%) 和多微生物 (57.7%) 感染,在rTHA中更常见.
- 慢性和多微生物PJI显示出更高的失败率 (p=0.041). 常见的共致病原体包括Enterococcus faecalis和Staphylococcus epidermidis. 这两种病原体是最常见的.
- 两阶段修改是最常见的手术 (46.2%),成功率为25%. 齐普罗夫洛克萨在抗菌治疗中表现出更高的成功率 (p=0.018).
结论:
- 蛋白质物种是罕见的PJI病原体,经常与慢性多微生物感染有关,特别是在部修订中.
- 这些感染的临床失败率很高,长期无再感染存活率有限 (在40个月后为22.6%).
- 齐普罗夫洛克萨显示出作为一种有效的抗菌剂的潜力,用于Proteus相关的PJIs.
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