Management of prosthetic joint infections in France: a national audit to identify key situations requiring innovation and homogenization

BMC Infectious Diseases

Marion Le Maréchal¹  Sébastien Lustig²  Cécile Batailler²  Tristan Ferry³  Zoé Cavalli⁴  André Ferreira⁵  Johan Courjon⁶  Jean-François Gonzalez⁷ 

[1] Centre Hospitalier de Grenoble, Grenoble, France;Université de Grenoble-Alpes, Grenoble, France;Claude Bernard University Lyon 1, Villeurbanne, France;Claude Bernard University Lyon 1, Villeurbanne, France;CRIOAc Lyon, Lyon, France;Hôpital de Mercy, Centre Hospitalier Régional de Metz-Thionville, Ars-Laquenexy, France;Société Française de chirurgie de la hanche et du genou, Paris, France;Université Côte d’Azur, CHU, INSERM, C3M, Nice, France;Infectiologie, Hôpital Archet 1, Centre Hospitalier Universitaire de Nice, Nice, France;Université Côte d’Azur, Nice, France;Université Côte d’Azur, CHU, INSERM, C3M, Nice, France;

关键词: Arthritis infection;    Clinical audit;    Joint prosthesis;    Rifampin;    Staphylococcus aureus;    Surveys and questionnaires;   

DOI  :  10.1186/s12879-021-06075-x

来源: Springer

【 摘 要 】

BackgroundProsthetic joint infections (PJI) are one of the most serious complication of arthroplasty. The management of PJI needs a multidisciplinary collaboration between orthopaedic surgeon, infectious disease specialist and microbiologist. In France, the management of PJI is organized around reference centres (CRIOACs). Our main objective was to perform an audit through a questionnaire survey based on clinical cases, to evaluate how French physicians manage PJI. Eligible participants were all physicians involved in care of patients presenting a PJI. Physicians could answer individually, or collectively during a multidisciplinary team meeting dedicated to PJI. The survey consisted as three questionnaires organized in a total of six clinical cases.ResultsAnswers from the CRIOACs to the three questionnaires were 92, 77, and 53%. Between 32 and 39% of respondents did not administer antibiotic prophylaxis despite positive S. aureus pre-operative documentation. One-stage exchange strategy was widely preferred in all clinical cases, with no difference between CRIOACs and other centres. Rifampicin was prescribed for S. aureus PJI, in a situation with (90–92%) or without any prosthesis (70%). There was no consensus for the total antibiotic regimen duration, with prescriptions from six to 12 weeks for a majority of respondents.ConclusionsSurgical strategy for the management of PJI was homogenous with a preference for a one-stage exchange strategy. Medical management was more heterogenous, which reflects the heterogeneity of those infections and difficulties to perform studies with strong conclusions.

【 授权许可】

CC BY