Higher risk of failure of methicillin-resistant Staphylococcus aureus prosthetic joint infections
Higher risk of failure of methicillin-resistant Staphylococcus aureus prosthetic joint infections
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DOI：
10.1097/blo.0b013e3181123d4e
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发表时间：
2007-08-01
影响因子：
4.2
通讯作者：
Marculescu, Camelia E.
中科院分区：
文献类型：
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作者：
Salgado, Cassandra D.;Dash, Sangita;Marculescu, Camelia E.
我们确定了甲氧西林耐药对金黄色葡萄球菌人工关节感染患者预后的影响。从1995年1月到2004年12月，137例人工关节感染中有33%是由沙门氏菌引起的。金黄色葡萄球菌（在单微生物或多微生物培养物中）。31例患者中有33例（24%）是甲氧西林敏感的S。12例患者中12例（9%）为耐甲氧西林金黄色葡萄球菌。金黄色。总体治疗失败率为38%。对甲氧西林敏感的S.金黄色葡萄球菌或耐甲氧西林的S.金黄色葡萄球菌人工关节感染在年龄、性别、合并症、关节年龄、受影响关节的既往外科手术、术后医疗并发症的数量或静脉内抗菌治疗的持续时间方面没有差异。耐甲氧西林的S.金黄色葡萄球菌人工关节感染的住院时间较长（中位数为15天与10天）。耐甲氧西林表皮葡萄与甲氧西林敏感的金黄色葡萄球菌相比，假体周围组织培养中的金黄色葡萄球菌导致治疗失败的风险更高（危害比，9.2; 95%置信区间，2.40-35.46）。当控制关节位置（全膝关节置换术与全髋关节置换术[风险比，5.8; 95%置信区间，1.52-22.19]）和内固定器械取出（风险比，0.24; 95%置信区间，0.077-0.75）时，金黄色葡萄球菌。应努力预防耐甲氧西林沙门氏菌。金黄色葡萄球菌感染的关节置换术，并开发新的治疗方式。
We determined the effect of methicillin resistance on the outcome of patients with Staphylococcus aureus prosthetic joint infections. From January 1995 to December 2004, 33% of 137 episodes of prosthetic joint infections were the result of S. aureus (in monomicrobial or polymicrobial cultures). Thirty-three (24%) episodes among 31 patients were the result of methicillin-susceptible S. aureus and 12 (9%) episodes among 12 patients were the result of methicillin-resistant S. aureus. Overall treatment failure rate was 38%. Patients with methicillin-susceptible S. aureus or methicillin-resistant S. aureus prosthetic joint infections did not differ in age, gender, comorbidities, joint age, prior surgical procedures performed on the affected joint, number of postsurgical medical complications, or duration of intravenous antimicrobial therapy. Patients with methicillin-resistant S. aureus prosthetic joint infection had longer hospital durations (median, 15 versus 10 days). Methicillin-resistant S. aureus in periprosthetic tissue culture resulted in a higher risk of treatment failure (hazard ratio, 9.2; 95% confidence interval, 2.40-35.46) than methicillin-susceptible S. aureus when controlling for joint location (total knee arthroplasty versus total hip arthroplasty [hazard ratio, 5.8; 95% confidence interval, 1.52-22.19]) and removal of hardware (hazard ratio, 0.24; 95% confidence interval, 0.077-0.75). Efforts should be made to prevent methicillin-resistant S. aureus infections of joint arthroplasties and develop new treatment modalities.