UNASSIGNED: Retrospective review of PJI cases was conducted from 1/2017 through 1/2021 compared to 1/2021 through 7/2022 to determine how many cases of C. striatum have occurred for each of these time points. From these cases, demographics, outcomes and risk factors for C. striatum PJI were recorded. The preserved clinical isolates from these cases were tested for susceptibility to different antibiotics.
UNASSIGNED: A statistically significant increase in the proportion of C. striatum PJI cases (1.98 to 7.84, p=0.0489) has occurred over the past 16 months at a single institution. Chronic wounds and exposure to daptomycin were associated with the majority of these cases. Susceptibility testing of the clinical isolates showed uniform susceptibility to vancomycin, linezolid and dalbavancin. Uniform resistance was seen with ciprofloxacin, tetracycline and doxycycline as well. Interestingly, 85.7% of the isolates displayed inducible daptomycin resistance after overnight exposure to daptomycin.
UNASSIGNED: C. striatum is an emerging PJI pathogen. It is important for clinicians to be cognizant that this pathogen can have inducible high level daptomycin resistance and that daptomycin is likely not a reliable antibiotic for these infections. While vancomycin and linezolid are the traditional antibiotics to use in these infections, other antibiotics such as dalbavancin, may also have utility, but more research is needed to determine the effectiveness of this antibiotic in C. striatum infections.
从2017年1月1日至2021年1月1日对PJI病例进行回顾性审查,与1/2021至7/2022进行比较,以确定每个时间点发生了多少纹状体梭菌病例。从这些案例中,人口统计,记录纹状体梭菌PJI的结局和危险因素.测试了这些病例中保存的临床分离株对不同抗生素的敏感性。
■在过去的16个月中,在一个机构中,纹状体C.PJI病例的比例在统计学上显着增加(1.98至7.84,p=0.0489)。慢性伤口和暴露于达托霉素与大多数这些病例有关。临床分离株的药敏试验显示对万古霉素的敏感性均匀,利奈唑胺和达巴万辛.环丙沙星的耐药性均匀,四环素和强力霉素。有趣的是,在暴露于达托霉素过夜后,85.7%的分离株显示出诱导型达托霉素抗性。
■C.纹状体是一种新兴的PJI病原体。对于临床医生来说,重要的是认识到这种病原体可能具有可诱导的高水平达托霉素抗性,并且达托霉素可能不是这些感染的可靠抗生素。虽然万古霉素和利奈唑胺是用于这些感染的传统抗生素,其他抗生素如达巴万金,也可能有效用,但是需要更多的研究来确定这种抗生素在纹状体梭菌感染中的有效性。