关键词: Guidelines Infections de prothèses articulaires MSSA Prosthetic joint infections Recommandations SASM

Mesh : Aged Aged, 80 and over Anti-Bacterial Agents / administration & dosage therapeutic use Arthritis, Infectious Biofilms Combined Modality Therapy Conservative Treatment Debridement Device Removal Drug Therapy, Combination Female Follow-Up Studies Guideline Adherence Hip Prosthesis / adverse effects Humans Infusions, Intravenous Knee Prosthesis / adverse effects Male Methicillin / pharmacology Middle Aged Practice Guidelines as Topic Proportional Hazards Models Prosthesis-Related Infections / drug therapy surgery therapy Recurrence Retrospective Studies Rifampin / administration & dosage therapeutic use Risk Factors Staphylococcal Infections / drug therapy surgery therapy Staphylococcus aureus / drug effects Treatment Failure

来  源:   DOI:10.1016/j.medmal.2017.09.016

Abstract:
OBJECTIVE: The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known.
METHODS: Retrospective (2000-2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure.
RESULTS: Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associated with treatment failure (hazard ratio 2.157; 95% CI [1.022-4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy, and a rifampicin-based regimen did not significantly influence patient outcome.
CONCLUSIONS: Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implant removal is needed to limit treatment failure.
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