部和膝关节的多微生物周围假肢关节感染:特征和治疗方法
Donara Margaryan1, Maria Virginia Dos Santos1, Carsten Perka1
1Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany.
The bone & joint journal
|November 30, 2025
概括
多微生物周围假肢关节感染 (PJI) 具有挑战性,通常需要多次手术和抗生素. 虽然治疗策略改善了结果,但难以治疗的生物和先前的修订增加了再感染的风险.
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
- 微生物学 微生物学
背景情况:
- 多微生物周围假肢关节感染 (PJI) 带来了重大的临床挑战.
- 有效的管理需要对致病原体和治疗方式有全面的了解.
研究的目的:
- 评估多微生物PJI的临床和微生物特征.
- 评估手术和抗生素策略及其长期结果.
- 确定影响治疗成功和患者预后的因素.
主要方法:
- 对39名患有多微生物PJI的患者进行了回顾性队列研究,这些患者正在进行植入物交换.
- 基于欧洲骨关节感染学会 (EBJIS) 修改的标准进行诊断.
- 采用标准化手术和抗生素方案;使用德尔菲标准评估结果.
主要成果:
- 葡萄球菌,阳性细菌和肠球菌是常见的病原体.
- 感染控制需要平均三次修订.
- 在1-3年后,部和膝盖PJIs的无感染生存率相当于部和膝盖PJIs,但在4年后,部PJIs的生存率明显更好.
- 难以治疗的生物增加了复发感染的风险.
结论:
- 多微生物PJI需要多学科的方法,因为高发病率.
- 标准化治疗改善了控制,但具有挑战性的病原体和先前的手术存在风险.
- 长期功能结果仍然低于最佳,这表明需要改进治疗方案.
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