Prosthetic Shoulder Joint Infection by Cutibacterium acnes: Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study

Antibiotics

Study Group on Osteoarticular Infections (GEIO)¹  the Spanish Network for Research in Infectious Pathology (REIPI)¹  Álvaro Auñón²  Mª Dolores del Toro³  Julia Praena-Segovia⁴  Laura Morata⁵  Luis Falgueras⁶  Dolors Rodríguez-Pardo⁷  Oscar Murillo⁸  Laura Guío⁹  José A. Iribarren^1,10  Rosa Escudero-Sanchez^1,11  Alicia Rico^1,12  Marta Fernandez-Sampedro^1,13  Natividad Benito^1,14  Helem H. Vilchez^1,15  Melchor Riera^1,15  Jaime Lora-Tamayo^1,16  Antonio Ramirez^1,17  Alfredo Jover-Sáenz^1,18 

[1] ;Bone and Joint Infection Unit, Department of Orthopaedic Surgery, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain;Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena CSIC, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, 41009 Sevilla, Spain;Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocio, 41013 Sevilla, Spain;Department of Infectious Diseases, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain;Infectious Diseases Department, Corporació Sanitària Parc Taulí, 08208 Barcelona, Spain;Infectious Diseases Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain;Infectious Diseases Department, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain;Infectious Diseases Department, Hospital Universitario Cruces, 48903 Vizcaya, Spain;Infectious Diseases Department, Hospital Universitario Donostia, Instituto BioDonostia, 20014 San Sebastián, Spain;Infectious Diseases Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;Infectious Diseases Unit and Clinical Microbiology, Hospital Universitario La Paz, 28046 Madrid, Spain;Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, 39008 Cantabria, Spain;Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau-Institut d’Investigació Biomèdica Sant Pau, Departament of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain;Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Fundació Institut d’Investigació Sanitària Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain;Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre “i + 12”, 28041 Madrid, Spain;Microbiologic Department, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain;Unit of Nosocomial Infection, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain;

关键词: Cutibacterium acnes;    prosthetic joint infection;    surgical and medical treatment;   

DOI  :  10.3390/antibiotics10050475

来源: DOAJ

【 摘 要 】

This retrospective, multicenter observational study aimed to describe the outcomes of surgical and medical treatment of C. acnes-related prosthetic joint infection (PJI) and the potential benefit of rifampin-based therapies. Patients with C. acnes-related PJI who were diagnosed and treated between January 2003 and December 2016 were included. We analyzed 44 patients with C. acnes-related PJI (median age, 67.5 years (IQR, 57.3–75.8)); 75% were men. The majority (61.4%) had late chronic infection according to the Tsukayama classification. All patients received surgical treatment, and most antibiotic regimens (43.2%) included β-lactam. Thirty-four patients (87.17%) were cured; five showed relapse. The final outcome (cure vs. relapse) showed a nonsignificant trend toward higher failure frequency among patients with previous prosthesis (OR: 6.89; 95% CI: 0.80–58.90) or prior surgery and infection (OR: 10.67; 95% IC: 1.08–105.28) in the same joint. Patients treated with clindamycin alone had a higher recurrence rate (40.0% vs. 8.8%). Rifampin treatment did not decrease recurrence in patients treated with β-lactams. Prior prosthesis, surgery, or infection in the same joint might be related to recurrence, and rifampin-based combinations do not seem to improve prognosis. Debridement and implant retention appear a safe option for surgical treatment of early PJI.

【 授权许可】

Unknown