Pseudomonas Prosthetic Joint Infections: A Review of 102 Episodes.

June 19, 2017 at 12:57 pm

J Bone Jt Infect. 2016 Jun 4;1:25-30.

Shah NB1, Osmon DR1, Steckelberg JM1, Sierra RJ2, Walker RC1, Tande AJ1, Berbari EF1.

Author information

1 Department of Internal Medicine and Division of Infectious Disease, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA.

2 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA.

Abstract

Background: The outcome of patients with Pseudomonas prosthetic joint infection (PS PJI) has not been well studied. The aim of this retrospective cohort study was to assess the outcome of patients with Pseudomonas PJI and to review risk factors associated with failure of therapy. Methods: Between 1/1969 and 12/2012, 102 episodes of PS PJI in 91 patients were identified. Results: The mean age at the time of diagnosis was 67.4 years; forty three percent had knee involvement. Over 40 percent had either diabetes mellitus or a history of gastrointestinal or genitourinary surgery. Nearly half (48 out of 102 episodes) received aminoglycoside monotherapy, while 25% received an anti-pseudomonal cephalosporin. The 2-year cumulative survival free from failure was 69% (95% CI, 56%-82%). Patients treated with resection arthroplasty, two-stage exchange, and debridement with implant retention had a 2-year cumulative survival free from failure of 80% (95% CI, 66%-95%), 83% (95% CI, 60%-100%), and 26% (95% CI, 23%-29%) respectively (P=0.0001). Conclusions: PS PJI’s are associated with a high failure rate. Patients treated with debridement and implant retention had a worse outcome.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423557/pdf/jbjiv01p0025.pdf

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Entry filed under: Antimicrobianos, Bacterias, Epidemiología, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, Infecciones nosocomiales, Infecciones osteo-articulares-musculares, Infecciones relacionadas a prótesis, Metodos diagnosticos, Profilaxis Antibiótica en Cirugía - PAC, REPORTS, Resistencia bacteriana, REVIEWS, Sepsis, Update.

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