A Bouaziz1, I Uçkay2, S Lustig3, A Boibieux1, D Lew2, P Hoffmeyer2, P Neyret4, C Chidiac5, T Ferry6. 1. Service de maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande rue de la Croix-Rousse, 69004 Lyon, France. 2. Hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland. 3. Service de chirurgie orthopédique, centre Albert-Trillat, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Université Claude-Bernard Lyon 1, 69100 Lyon, France; Centre de référence des IOA complexes de Lyon, Lyon, France. 4. Service de chirurgie orthopédique, centre Albert-Trillat, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Université Claude-Bernard Lyon 1, 69100 Lyon, France. 5. Service de maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande rue de la Croix-Rousse, 69004 Lyon, France; Université Claude-Bernard Lyon 1, 69100 Lyon, France; Centre de référence des IOA complexes de Lyon, Lyon, France; Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, centre international de recherche en infectiologie (CIRI), 69007 Lyon, France. 6. Service de maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 93, Grande rue de la Croix-Rousse, 69004 Lyon, France; Université Claude-Bernard Lyon 1, 69100 Lyon, France; Centre de référence des IOA complexes de Lyon, Lyon, France; Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, centre international de recherche en infectiologie (CIRI), 69007 Lyon, France. Electronic address: tristan.ferry@univ-lyon1.fr.
Abstract
OBJECTIVE: The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known. PATIENTS AND METHODS: Retrospective (2000-2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure. RESULTS: Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associated with treatment failure (hazard ratio 2.157; 95% CI [1.022-4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy, and a rifampicin-based regimen did not significantly influence patient outcome. CONCLUSION: Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implant removal is needed to limit treatment failure.
OBJECTIVE: The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known. PATIENTS AND METHODS: Retrospective (2000-2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure. RESULTS: Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associated with treatment failure (hazard ratio 2.157; 95% CI [1.022-4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy, and a rifampicin-based regimen did not significantly influence patient outcome. CONCLUSION: Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implant removal is needed to limit treatment failure.
Authors: Pierre Chauvelot; Tristan Ferry; Virginie Tafani; Alan Diot; Jason Tasse; Anne Conrad; Christian Chidiac; Evelyne Braun; Sébastien Lustig; Frédéric Laurent; Florent Valour Journal: Front Med (Lausanne) Date: 2021-01-21
Authors: H Scheper; L M Gerritsen; B G Pijls; S A Van Asten; L G Visser; M G J De Boer Journal: Open Forum Infect Dis Date: 2021-07-01 Impact factor: 3.835