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| Pàgina inicial > Articles > Articles publicats > Rates and Predictors of Treatment Failure in Staphylococcus aureus Prosthetic Joint Infections According to Different Management Strategies : |
(Universitat Autònoma de Barcelona. Departament de Medicina) (Universitat Autònoma de Barcelona. Departament de Medicina) (IRCCS Azienda Ospedaliero Universitaria di Bologna) (Universitat Pompeu Fabra) (Institut d'Investigació Biomèdica de Bellvitge) (Oxford University Hospitals NHS Foundation Trust (Regne Unit)) (University Medical Center Utrecht. Department of Medical Microbiology) (Jena University Hospital (Alemanya)) (Centro de Investigación Biomédica en Red de Enfermedades Infecciosas) (Instituto de Biomedicina de Sevilla) (Instituto de Biomedicina de Sevilla)
| Data: | 2022 |
| Resum: | Guidelines have improved the management of prosthetic joint infections (PJI). However, it is necessary to reassess the incidence and risk factors for treatment failure (TF) of Staphylococcus aureus PJI (SA-PJI) including functional loss, which has so far been neglected as an outcome. A retrospective cohort study of SA-PJI was performed in 19 European hospitals between 2014 and 2016. The outcome variable was TF, including related mortality, clinical failure and functional loss both after the initial surgical procedure and after all procedures at 18 months. Predictors of TF were identified by logistic regression. Landmark analysis was used to avoid immortal time bias with rifampicin when debridement, antibiotics and implant retention (DAIR) was performed. One hundred twenty cases of SA-PJI were included. TF rates after the first and all surgical procedures performed were 32. 8% and 24. 2%, respectively. After all procedures, functional loss was 6. 0% for DAIR and 17. 2% for prosthesis removal. Variables independently associated with TF for the first procedure were Charlson ≥ 2, haemoglobin < 10 g/dL, bacteraemia, polymicrobial infection and additional debridement(s). For DAIR, TF was also associated with a body mass index (BMI) > 30 kg/m 2 and delay of DAIR, while rifampicin use was protective. For all procedures, the variables associated with TF were haemoglobin < 10 g/dL, hip fracture and additional joint surgery not related to persistent infection. TF remains common in SA-PJI. Functional loss accounted for a substantial proportion of treatment failures, particularly after prosthesis removal. Use of rifampicin after DAIR was associated with a protective effect. Among the risk factors identified, anaemia and obesity have not frequently been reported in previous studies. This study is registered at clinicaltrials. gov, registration no. NCT03826108. The online version contains supplementary material available at 10. 1007/s40121-022-00701-0. The online version contains supplementary material available at 10. 1007/s40121-022-00701-0. |
| Ajuts: | Ministerio de Economía y Competitividad RD16/0016/0001 Ministerio de Economía y Competitividad RD16/0016/0002 Ministerio de Economía y Competitividad RD16/0016/0005 Ministerio de Economía y Competitividad RD16/0016/0009 Ministerio de Economía y Competitividad RD16/0016/0011 Ministerio de Economía y Competitividad RD16/0016/0015 |
| Nota: | Altres ajuts: Innovative Medicines Initiative: 115523 |
| Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.  |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Matèria: | Prosthetic joint infection ; Staphylococcus aureus ; Outcome ; Clinical failure ; Functional failure |
| Publicat a: | Infectious Diseases and Therapy, Vol. 11 (october 2022) , p. 2177-2203, ISSN 2193-6382 |
