Group B streptococcus in prosthetic hip and knee joint-associated infections
Group B streptococcus in prosthetic hip and knee joint-associated infections
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DOI：
10.1016/j.jhin.2011.04.022
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发表时间：
2011-09-01
影响因子：
6.9
通讯作者：
Zimmerli, W.
中科院分区：
文献类型：
--
作者：
Sendi, P.;Christensson, B.;Zimmerli, W.
非妊娠成人中侵袭性 B 族链球菌 (GBS) 感染的发病率正在增加。对于假体周围感染 (PJI) 中的 GBS 知之甚少。我们的目的是分析 GBS PJI 的临床表现及其与结果相关的治疗。对从 10 个中心收集的 36 个 GBS PJI 的特征进行了调查。在 34 次发作中，可进行≥ 2 年的随访检查，以便进行治疗和结果分析。大多数感染 (75%) 发生在植入后 3 个月以上。大多数患者（91%）至少患有一种合并症； 69% 出现急性症状，83% 出现假体周围软组织受损。在 34 次发作中，有 20 次尝试了清创和保留植入物，但其中 5 次的假体最终被移除。因此，在 19 次 (56%) 事件中，植入物被移除，其中 14 次立即移除。在四集中，移除是永久性的。青霉素衍生物和克林霉素是最常用的抗菌药物（68%）。 94% 的感染被治愈，82% 的功能活动得以保留。如果症状持续时间短、假体稳定且组织损伤轻微（10/10 vs 3/10 发作，P = 0.003），则保留种植体的清创术是成功的。符合已发布算法的手术与良好的结果相关（P = 0.049）。 (C) 2011 年医疗保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
The incidence of invasive group B streptococcus (GBS) infections in non-pregnant adults is increasing. Little is known about GBS in periprosthetic joint infections (PJIs). We aimed to analyse the clinical presentation of GBS PJI and its treatment in association with the outcome. The characteristics of 36 GBS PJIs collected from 10 centres were investigated. In 34 episodes, follow-up examination of >= 2 years was available, allowing treatment and outcome analysis. Most infections (75%) occurred >= 3 months after implantation. Most patients (91%) had at least one comorbidity; 69% presented with acute symptoms and 83% with damaged periprosthetic soft tissue. In 20 of 34 episodes debridement and retention of implant was attempted, but in five of these the prosthesis was ultimately removed. Hence, in 19 (56%) episodes, the implant was removed, including 14 immediate removals. In four episodes the removal was permanent. Penicillin derivatives and clindamycin were the most common antimicrobials administered (68%). In 94% the infection was cured, and in 82% functional mobility preserved. Debridement with implant retention was successful if the duration of symptoms was short, the prosthesis stable, and the tissue damage minor (10/10 vs 3/10 episodes, P = 0.003). Surgery that complied with a published algorithm was associated with a favourable outcome (P = 0.049). (C) 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.