Early prosthetic joint infection: outcomes with debridement and implant retention followed by antibiotic therapy
Early prosthetic joint infection: outcomes with debridement and implant retention followed by antibiotic therapy
复制标题
DOI：
10.1111/j.1469-0691.2010.03333.x
复制
发表时间：
2011-11-01
影响因子：
14.2
通讯作者：
Ariza, J.
中科院分区：
文献类型：
--
作者：
Cobo, J.;Garcia San Miguel, L.;Ariza, J.
最近的专家评论推荐保守的手术策略-清创和冲洗，抗生素和种植体保留(DAIR) -用于大多数早期手术后假体关节感染（PJI）。然而，关于DAIR的成功率，已发表的系列存在差异，而且大多数系列的规模很小。在这项由DAIR管理的早期PJI的前瞻性多中心队列研究中，分析了与DAIR失败相关的因素。在139例早期PJI中，117例采用DAIR治疗，67例（57.3%）患者感染治愈，种植体经明确抗菌治疗后恢复。在35例（29.9%）患者中，DAIR失败，随访期间需要取出假体。最后，15例患者（12.8%）因怀疑或确认持续感染需要慢性抑制抗菌药物治疗。耐甲氧西林金黄色葡萄球菌引起的感染（72.7%失败，p < 0.05）和在同一家医院治疗的感染（80.0%失败，p < 0.05）
Recent expert reviews recommend a conservative surgical strategy - debridement and irrigation, antibiotics and implant retention (DAIR) - for most early post-surgical prosthetic joint infections (PJI). However, differences exist in published series regarding success rates with DAIR, and the size of most series is small. In this prospective multicenter cohort study of early PJI managed by DAIR, factors associated with failure of the DAIR were analyzed. Out of 139 early PJI, 117 cases managed with DAIR were studied For 67 patients (57.3%), infection was cured and the implant was salvaged with definite antimicrobial therapy. In 35 (29.9%) DAIR failed and removal of the prosthesis was necessary during follow-up. Finally, 15 patients (12.8%) needed chronic suppressive antimicrobial therapy due to suspected or confirmed persistent infection. Infections due to methicillin-resistant S. aureus (72.7% failed; p 0.05) and those treated at one of the hospitals (80.0% failed; p