Gram-negative prosthetic joint infection treated with debridement, prosthesis retention and antibiotic regimens including a fluoroquinolone
Gram-negative prosthetic joint infection treated with debridement, prosthesis retention and antibiotic regimens including a fluoroquinolone
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DOI：
10.1111/j.1469-0691.2010.03361.x
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发表时间：
2011-06-01
影响因子：
14.2
通讯作者：
Stanley, P. A.
中科院分区：
文献类型：
--
作者：
Aboltins, C. A.;Dowsey, M. M.;Stanley, P. A.
需要有关通过假体保留和手术清创治疗的革兰氏阴性假体关节感染的治疗结果的信息，特别是在使用氟喹诺酮类等生物膜活性抗生素的情况下。对 17 名连续接受假体保留和手术清创治疗的早期革兰氏阴性假体关节感染患者的结果进行了分析。 16 名患者中分离出肠杆菌科细菌，13 名（76%）患者中感染与其他微生物混合。中位关节年龄为 17 天，清创前症状持续时间中位为 7 天。所有患者最初均接受静脉注射 β-内酰胺抗生素治疗，随后 14 名患者接受口服环丙沙星治疗。在中位随访 28 个月期间，两名患者出现治疗失败。只有一名患者因复发性革兰氏阴性感染而导致失败，并且该患者未接受环丙沙星治疗。无治疗失败的 2 年生存率为 94%（95% CI，63-99%）。手术清创术保留假体，结合包括环丙沙星在内的抗生素治疗方案是有效的，对于早期革兰氏阴性假体关节感染的患者应考虑使用。
Information is required about treatment outcomes of Gram-negative prosthetic joint infections treated with prosthesis retention and surgical debridement, especially where biofilm-active antibiotics such as fluoroquinolones are used. The outcome of 17 consecutive patients with an early Gram-negative prosthetic joint infection who had been treated with prosthesis retention and surgical debridement was analysed. Enterobacteriaceae were isolated in 16 patients and infections were mixed with other organisms in 13 (76%) patients. The median joint age was 17 days and the median duration of symptoms before debridement was 7 days. All patients initially received intravenous beta-lactam antibiotic therapy and 14 patients were then treated with oral ciprofloxacin. Treatment failure occurred in two patients over a median period of follow-up of 28 months. In only one patient was a relapsed Gram-negative infection responsible for the failure and this patient had not been treated with ciprofloxacin. The 2-year survival rate free of treatment failure was 94% (95% CI, 63-99%). Prosthesis retention with surgical debridement, in combination with antibiotic regimens including ciprofloxacin, was effective and should be considered for patients with early Gram-negative prosthetic joint infection.