全球视角对周围假肢关节感染的管理
Nicolas S Piuzzi1, Irene K Sigmund2, Pablo A Slullitel3
1Cleveland Clinic, Cleveland, Ohio.
The Journal of bone and joint surgery. American volume
|November 28, 2025
概括
周围假肢关节感染 (PJI) 是一个日益严重的全球性问题,死亡率高. 诊断和个性化治疗的进步为管理这些具有挑战性的感染提供了新的希望.
科学领域:
- 整形外科手术 整形外科手术
- 传染病 传染病 传染病
- 生物医学工程 生物医学工程
背景情况:
- 周围假肢关节感染 (PJI) 率在全球范围内不断增加,呈现出显著的区域差异.
- PJI与高5年死亡率 (15-25%) 相关,超过了一些早期癌症的死亡率.
- 尽管诊断标准得到了改进,但诊断由细微生物形成的细菌引起的感染仍然是全球面临的重大挑战.
研究的目的:
- 审查PJI目前的诊断挑战和治疗策略.
- 强调在PJI管理中需要标准化的结果报告.
- 探索PJI治疗的新兴前沿,包括个性化医学和AI.
主要方法:
- 对PJI诊断和治疗方式的当前文献的综述.
- 诊断标准的分析,包括突液分析,新型培养和分子技术.
- 评估外科手术方法,如DAIR,1阶段,2阶段和1.5阶段的手术.
主要成果:
- 诊断准确度有所提高,但对于特定的微生物仍然存在挑战.
- 由于后勤和资源因素,处理策略 (DAIR,分阶段程序) 在区域范围内有所不同.
- 关于报告治疗成功的阶层框架的建议旨在标准化研究和基准测试.
结论:
- 标准化报告框架对于PJI中的比较研究和结果基准测试至关重要.
- 免疫遗传学,人工智能驱动的风险建模和精准医学等新兴领域正在为创新,个性化的PJI管理铺平道路.
- 全球合作和研究联盟对于推进PJI治疗策略至关重要.
相关概念视频
Endocarditis III: Medical Management
199
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...
199
Healthcare Associated Infections II: Preventive Measures
3.5K
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...
3.5K
Acute Pyelonephritis II: Diagnostic Studies and Management
289
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
289
Factors Affecting the Risk of Infection
13.2K
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...
13.2K
Endocarditis IV: Nursing Management
303
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
303
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
5.3K
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.
5.3K


