Artículo
Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study
Autor/es | Gómez-Junyent, Joan
Lora-Tamayo, Jaime Baraia-Etxaburu, Josu Sánchez-Somolinos, Mar Iribarren, José Antonio Rodríguez-Pardo, Dolors Toro López, María Dolores del Murillo, Óscar |
Departamento | Universidad de Sevilla. Departamento de Medicina |
Fecha de publicación | 2021 |
Fecha de depósito | 2022-09-27 |
Publicado en |
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Resumen | Objectives: To compare the characteristics and outcomes of cases with acute prosthetic joint infection (PJI; early post-surgical or hematogenous) by Staphylococcus aureus managed with implant removal (IRm) or debridement ... Objectives: To compare the characteristics and outcomes of cases with acute prosthetic joint infection (PJI; early post-surgical or hematogenous) by Staphylococcus aureus managed with implant removal (IRm) or debridement and retention (DAIR). To analyze the outcomes of all cases managed with IRm (initially or after DAIR failure). Methods: Retrospective, multicenter, cohort study of PJI by S. aureus (2003–2010). Overall failure included mortality within 60 days since surgery and local failure due to staphylococcal persistence/relapse. Results: 499 cases, 338 initially managed with DAIR, 161 with IRm. Mortality was higher in acute PJI managed initially with IRm compared to DAIR, but not associated with the surgical procedure, after propensity score matching. Underlying conditions, hemiarthroplasty, and methicillin-resistant S. aureus were risk factors for mortality. Finally, 249 cases underwent IRm (88 after DAIR failure); overall failure was 15.6%. Local failure (9.3%) was slightly higher in cases with several comorbidities, but independent of previous DAIR, type of IRm, and rifampin treatment. Conclusions: In a large multicenter study of S. aureus PJI managed with IRm, failure was low, but mortality significant, especially in cases with acute PJI and underlying conditions, but not associated with the IRm itself. Rifampin efficacy was limited in this setting. |
Identificador del proyecto | REIPI RD16/0016/0005
FPU 14/03124 |
Cita | Gómez-Junyent, J., Lora-Tamayo, J., Baraia-Etxaburu, J., Sánchez-Somolinos, M., Iribarren, J.A., Rodríguez-Pardo, D.,...,Murillo, Ó. (2021). Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study. Antibiotics, 10 (2) |
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