cc7681a1086f3b96c9c6a339ed470973 255503.pdf 5feefcdd76739c8d83847a1dbed100efbb2b5e80 255503.pdf 7649f5ccadce3d3f578302496dce963849478801f4055179c0079dd728953a14 255503.pdf Title: Prosthetic Shoulder Joint Infection by Cutibacterium acnes: Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study Subject: This retrospective, multicenter observational study aimed to describe the outcomes of surgical and medical treatment of C. acnes-related prosthetic joint infection (PJI) and the potential benefit of rifampin-based therapies. Patients with C. acnes-related PJI who were diagnosed and treated between January 2003 and December 2016 were included. We analyzed 44 patients with C. acnes-related PJI (median age, 67.5 years (IQR, 57.3–75.8)); 75% were men. The majority (61.4%) had late chronic infection according to the Tsukayama classification. All patients received surgical treatment, and most antibiotic regimens (43.2%) included -lactam. Thirty-four patients (87.17%) were cured; five showed relapse. The final outcome (cure vs. relapse) showed a nonsignificant trend toward higher failure frequency among patients with previous prosthesis (OR: 6.89; 95% CI: 0.80–58.90) or prior surgery and infection (OR: 10.67; 95% IC: 1.08–105.28) in the same joint. Patients treated with clindamycin alone had a higher recurrence rate (40.0% vs. 8.8%). Rifampin treatment did not decrease recurrence in patients treated with -lactams. Prior prosthesis, surgery, or infection in the same joint might be related to recurrence, and rifampin-based combinations do not seem to improve prognosis. Debridement and implant retention appear a safe option for surgical treatment of early PJI. Keywords: Cutibacterium acnes; prosthetic joint infection; surgical and medical treatment Author: Helem H. Vilchez, Rosa Escudero-Sanchez, Marta Fernandez-Sampedro, Oscar Murillo, Álvaro Auñón, Dolors Rodríguez-Pardo, Alfredo Jover-Sáenz, Mª Dolores del Toro, Alicia Rico, Luis Falgueras, Julia Praena-Segovia, Laura Guío, José A. Iribarren, Jaime Lora-Tamayo, Natividad Benito, Laura Morata, Antonio Ramirez, Melchor Riera, Study Group on Osteoarticular Infections (GEIO) and the Spanish Network for Research in Infectious Pathology (REIPI) Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Apr 21 10:18:57 2021 CEST ModDate: Wed Apr 21 10:32:00 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 657979 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- OHKNFJ+VnURWPalladioL Type 1 Custom yes yes no 10 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 15 0 HHGMXQ+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 KXDAHP+URWPalladioL-Bold Type 1 Custom yes yes no 24 0 BHNIAL+URWPalladioL-BoldItal Type 1 Custom yes yes no 28 0 FTXDDC+URWPalladioL-Roma Type 1 Custom yes yes no 32 0 FFAYKL+VnURWPalladioL-Bold Type 1 Custom yes yes no 36 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 45 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 67 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 71 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 75 0 EKLGIO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 97 0 EKLGKA+PalatinoLinotype TrueType WinAnsi yes yes no 100 0 EKLGOA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 103 0 WZGEIC+CMBSY10 Type 1 Builtin yes yes no 110 0 EKLGIO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 134 0 EKLGKA+PalatinoLinotype TrueType WinAnsi yes yes no 137 0 EKLGOA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 140 0 PDTLUH+CMSY10 Type 1 Builtin yes yes no 155 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2022-03-10 03:03:06 CET RepresentationInformation: 255503.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-03-09 12:24:53 CET Size: 657979 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 316 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Children: Item: Title: Patient Baseline and Clinical Characteristics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Microbiological Characteristics and Antimicrobial Susceptibility Patterns Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Surgical and Medical Therapy Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Treatment Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Children: Item: Title: Study Design, Patients, and Settings Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Data Collection Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Definitions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Follow-Up and Treatment Success Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Microbiological Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Info: Title: Prosthetic Shoulder Joint Infection by Cutibacterium acnes: Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study Author: Helem H. Vilchez, Rosa Escudero-Sanchez, Marta Fernandez-Sampedro, Oscar Murillo, Álvaro Auñón, Dolors Rodríguez-Pardo, Alfredo Jover-Sáenz, Mª Dolores del Toro, Alicia Rico, Luis Falgueras, Julia Praena-Segovia, Laura Guío, José A. Iribarren, Jaime Lora-Tamayo, Natividad Benito, Laura Morata, Antonio Ramirez, Melchor Riera, Study Group on Osteoarticular Infections (GEIO) and the Spanish Network for Research in Infectious Pathology (REIPI) Subject: This retrospective, multicenter observational study aimed to describe the outcomes of surgical and medical treatment of C. acnes-related prosthetic joint infection (PJI) and the potential benefit of rifampin-based therapies. Patients with C. acnes-related PJI who were diagnosed and treated between January 2003 and December 2016 were included. We analyzed 44 patients with C. acnes-related PJI (median age, 67.5 years (IQR, 57.3 75.8)); 75% were men. The majority (61.4%) had late chronic infection according to the Tsukayama classification. All patients received surgical treatment, and most antibiotic regimens (43.2%) included -lactam. Thirty-four patients (87.17%) were cured; five showed relapse. The final outcome (cure vs. relapse) showed a nonsignificant trend toward higher failure frequency among patients with previous prosthesis (OR: 6.89; 95% CI: 0.80 58.90) or prior surgery and infection (OR: 10.67; 95% IC: 1.08 105.28) in the same joint. Patients treated with clindamycin alone had a higher recurrence rate (40.0% vs. 8.8%). Rifampin treatment did not decrease recurrence in patients treated with -lactams. Prior prosthesis, surgery, or infection in the same joint might be related to recurrence, and rifampin-based combinations do not seem to improve prognosis. Debridement and implant retention appear a safe option for surgical treatment of early PJI. Keywords: Cutibacterium acnes; prosthetic joint infection; surgical and medical treatment Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Apr 21 10:18:57 CEST 2021 ModDate: Wed Apr 21 10:32:00 CEST 2021 ID: 0xa24f7b30a129bb0d2c40425fb5bf6d86, 0xa24f7b30a129bb0d2c40425fb5bf6d86 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: FTXDDC+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: FTXDDC+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: HHGMXQ+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 121 FontDescriptor: FontName: HHGMXQ+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: FFAYKL+VnURWPalladioL-Bold FontSubset: true FirstChar: 129 LastChar: 226 FontDescriptor: FontName: FFAYKL+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: KXDAHP+URWPalladioL-Bold FontSubset: true FirstChar: 2 LastChar: 241 FontDescriptor: FontName: KXDAHP+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: OHKNFJ+VnURWPalladioL FontSubset: true FirstChar: 129 LastChar: 226 FontDescriptor: FontName: OHKNFJ+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: PDTLUH+CMSY10 FontSubset: true FirstChar: 21 LastChar: 21 FontDescriptor: FontName: PDTLUH+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: BHNIAL+URWPalladioL-BoldItal FontSubset: true FirstChar: 67 LastChar: 117 FontDescriptor: FontName: BHNIAL+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: WZGEIC+CMBSY10 FontSubset: true FirstChar: 15 LastChar: 15 FontDescriptor: FontName: WZGEIC+CMBSY10 Flags: Symbolic FontBBox: -26, -940, 1332, 825 FontFile: true Font: BaseFont: LWLIVD+EURM10 FontSubset: true FirstChar: 12 LastChar: 12 FontDescriptor: FontName: LWLIVD+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 FontFile: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 35, 759, 167, 795 Annotation: Subtype: Link Rect: 515, 759, 560, 795 Annotation: Subtype: Link Rect: 129, 640, 140, 654 Annotation: Subtype: Link Rect: 256, 640, 267, 654 Annotation: Subtype: Link Rect: 152, 628, 163, 641 Annotation: Subtype: Link Rect: 265, 628, 276, 641 Annotation: Subtype: Link Rect: 378, 628, 390, 641 Annotation: Subtype: Link Rect: 449, 628, 460, 641 Annotation: Subtype: Link Rect: 494, 615, 505, 629 Annotation: Subtype: Link Rect: 112, 359, 154, 367 Annotation: Subtype: Link Rect: 35, 346, 154, 355 Annotation: Subtype: Link Rect: 35, 336, 96, 343 Annotation: Subtype: Link Rect: 35, 162, 97, 184 Annotation: Subtype: Link Rect: 153, 89, 154, 98 Annotation: Subtype: Link Rect: 35, 77, 147, 86 Annotation: Subtype: Link Rect: 120, 17, 281, 28 Annotation: Subtype: Link Rect: 398, 17, 558, 28 Annotation: Subtype: Link Rect: 35, 494, 87, 513 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 444, 518, 451, 527 ActionDest: 163 Annotation: Subtype: Link Rect: 454, 518, 461, 527 ActionDest: 163 Annotation: Subtype: Link Rect: 203, 468, 210, 477 ActionDest: 163 Annotation: Subtype: Link Rect: 211, 468, 218, 477 ActionDest: 163 Annotation: Subtype: Link Rect: 218, 468, 225, 477 ActionDest: 163 Annotation: Subtype: Link Rect: 271, 430, 278, 439 ActionDest: 163 Annotation: Subtype: Link Rect: 278, 430, 285, 439 ActionDest: 163 Annotation: Subtype: Link Rect: 312, 342, 319, 351 ActionDest: 163 Annotation: Subtype: Link Rect: 320, 342, 327, 351 ActionDest: 163 Annotation: Subtype: Link Rect: 327, 342, 334, 351 ActionDest: 163 Annotation: Subtype: Link Rect: 186, 292, 193, 301 ActionDest: 163 Annotation: Subtype: Link Rect: 193, 292, 205, 301 ActionDest: 163 Annotation: Subtype: Link Rect: 350, 217, 362, 226 ActionDest: 163 Annotation: Subtype: Link Rect: 307, 179, 319, 188 ActionDest: 163 Annotation: Subtype: Link Rect: 319, 179, 331, 188 ActionDest: 163 Annotation: Subtype: Link Rect: 380, 129, 387, 138 ActionDest: 163 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 273, 666, 280, 678 ActionDest: 87 Annotation: Subtype: Link Rect: 433, 361, 440, 373 ActionDest: 107 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 424, 322, 431, 334 ActionDest: 107 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 515, 666, 522, 678 ActionDest: 114 Annotation: Subtype: Link Rect: 297, 326, 304, 338 ActionDest: 114 Annotation: Subtype: Link Rect: 195, 200, 202, 212 ActionDest: 117 Page: Sequence: 6 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 285, 720, 292, 732 ActionDest: 120 Annotation: Subtype: Link Rect: 298, 645, 305, 656 ActionDest: 117 Annotation: Subtype: Link Rect: 281, 215, 288, 227 ActionDest: 120 Annotation: Subtype: Link Rect: 314, 165, 321, 177 ActionDest: 146 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 233, 439, 240, 448 ActionDest: 163 Annotation: Subtype: Link Rect: 240, 439, 247, 448 ActionDest: 163 Annotation: Subtype: Link Rect: 248, 439, 260, 448 ActionDest: 163 Annotation: Subtype: Link Rect: 263, 439, 275, 448 ActionDest: 163 Annotation: Subtype: Link Rect: 204, 389, 216, 398 ActionDest: 163 Annotation: Subtype: Link Rect: 219, 389, 231, 398 ActionDest: 163 Annotation: Subtype: Link Rect: 333, 376, 340, 385 ActionDest: 163 Annotation: Subtype: Link Rect: 341, 376, 348, 385 ActionDest: 163 Annotation: Subtype: Link Rect: 348, 376, 360, 385 ActionDest: 163 Annotation: Subtype: Link Rect: 284, 326, 291, 335 ActionDest: 163 Annotation: Subtype: Link Rect: 292, 326, 304, 335 ActionDest: 163 Annotation: Subtype: Link Rect: 304, 326, 316, 335 ActionDest: 163 Annotation: Subtype: Link Rect: 418, 250, 425, 260 ActionDest: 163 Annotation: Subtype: Link Rect: 425, 251, 432, 260 ActionDest: 163 Annotation: Subtype: Link Rect: 432, 250, 444, 260 ActionDest: 163 Annotation: Subtype: Link Rect: 294, 200, 306, 209 ActionDest: 163 Annotation: Subtype: Link Rect: 307, 200, 319, 209 ActionDest: 166 Annotation: Subtype: Link Rect: 319, 200, 331, 209 ActionDest: 166 Annotation: Subtype: Link Rect: 411, 138, 418, 147 ActionDest: 163 Annotation: Subtype: Link Rect: 419, 138, 426, 147 ActionDest: 163 Annotation: Subtype: Link Rect: 426, 138, 438, 147 ActionDest: 163 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 468, 722, 475, 731 ActionDest: 163 Annotation: Subtype: Link Rect: 475, 722, 482, 731 ActionDest: 163 Annotation: Subtype: Link Rect: 482, 722, 494, 731 ActionDest: 166 Annotation: Subtype: Link Rect: 336, 672, 343, 681 ActionDest: 163 Annotation: Subtype: Link Rect: 344, 672, 355, 681 ActionDest: 163 Annotation: Subtype: Link Rect: 459, 634, 471, 643 ActionDest: 163 Annotation: Subtype: Link Rect: 484, 584, 496, 593 ActionDest: 166 Annotation: Subtype: Link Rect: 339, 509, 346, 518 ActionDest: 163 Annotation: Subtype: Link Rect: 349, 509, 356, 518 ActionDest: 163 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 473, 647, 480, 656 ActionDest: 163 Annotation: Subtype: Link Rect: 481, 647, 493, 656 ActionDest: 163 Annotation: Subtype: Link Rect: 276, 584, 288, 593 ActionDest: 166 Annotation: Subtype: Link Rect: 291, 584, 303, 593 ActionDest: 166 Annotation: Subtype: Link Rect: 193, 244, 205, 253 ActionDest: 166 Annotation: Subtype: Link Rect: 206, 244, 218, 253 ActionDest: 166 Page: Sequence: 11 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 520, 619, 557, 630 Annotation: Subtype: Link Rect: 149, 586, 186, 596 Annotation: Subtype: Link Rect: 353, 562, 391, 573 Annotation: Subtype: Link Rect: 519, 539, 557, 550 Annotation: Subtype: Link Rect: 59, 528, 95, 538 Annotation: Subtype: Link Rect: 229, 504, 267, 515 Annotation: Subtype: Link Rect: 273, 504, 309, 515 Annotation: Subtype: Link Rect: 309, 481, 346, 492 Annotation: Subtype: Link Rect: 436, 458, 473, 469 Annotation: Subtype: Link Rect: 479, 458, 515, 469 Annotation: Subtype: Link Rect: 389, 435, 427, 446 Annotation: Subtype: Link Rect: 433, 435, 469, 446 Annotation: Subtype: Link Rect: 330, 412, 368, 423 Annotation: Subtype: Link Rect: 374, 412, 410, 423 Annotation: Subtype: Link Rect: 520, 389, 557, 400 Annotation: Subtype: Link Rect: 170, 355, 207, 366 Annotation: Subtype: Link Rect: 214, 355, 250, 366 Annotation: Subtype: Link Rect: 474, 332, 511, 343 Annotation: Subtype: Link Rect: 517, 332, 553, 343 Annotation: Subtype: Link Rect: 104, 310, 141, 320 Annotation: Subtype: Link Rect: 148, 310, 184, 320 Annotation: Subtype: Link Rect: 59, 275, 97, 285 Annotation: Subtype: Link Rect: 473, 251, 510, 262 Annotation: Subtype: Link Rect: 516, 251, 552, 262 Annotation: Subtype: Link Rect: 243, 228, 280, 239 Annotation: Subtype: Link Rect: 286, 228, 322, 239 Annotation: Subtype: Link Rect: 478, 205, 515, 216 Annotation: Subtype: Link Rect: 521, 205, 557, 216 Annotation: Subtype: Link Rect: 171, 182, 208, 193 Annotation: Subtype: Link Rect: 273, 159, 310, 170 Annotation: Subtype: Link Rect: 397, 136, 435, 147 Annotation: Subtype: Link Rect: 396, 113, 434, 124 Annotation: Subtype: Link Rect: 254, 79, 291, 90 Annotation: Subtype: Link Rect: 95, 56, 133, 67 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 127, 722, 164, 732 Annotation: Subtype: Link Rect: 445, 709, 483, 720 Annotation: Subtype: Link Rect: 489, 709, 525, 720 Annotation: Subtype: Link Rect: 165, 686, 202, 697 Annotation: Subtype: Link Rect: 209, 686, 245, 697 Annotation: Subtype: Link Rect: 460, 663, 497, 674 Annotation: Subtype: Link Rect: 184, 640, 332, 651 Annotation: Subtype: Link Rect: 56, 617, 117, 628 Annotation: Subtype: Link Rect: 236, 617, 274, 628 Annotation: Subtype: Link Rect: 280, 617, 316, 628 Annotation: Subtype: Link Rect: 125, 571, 380, 582 Annotation: Subtype: Link Rect: 250, 548, 288, 559 Checksum: 07a30e59 Type: CRC32 Checksum: cc7681a1086f3b96c9c6a339ed470973 Type: MD5 Checksum: 5feefcdd76739c8d83847a1dbed100efbb2b5e80 Type: SHA-1