Anne Coste1, Mélanie Poinot2, Sophie Panaget1, Bénédicte Albert3, Adrien Kaladji4,5, Hervé Le Bars6, Nasr Bahaa3, Badra Ali3, Caroline Piau7, Vincent Cattoir7,8, Claire de Moreuil1, Matthieu Revest9,10,11, Rozenn Le Berre12,13. 1. Service de Médecine Interne, Vasculaire et Pneumologie, Hôpital La Cavale Blanche, CHRU Brest, Brest, France. 2. Infectious Diseases and Intensive Care Unit, CHU Rennes, Rennes, France. 3. Service de Chirurgie Cardiaque Thoracique et Vasculaire, CHRU Brest, Brest, France. 4. Centre of Cardiovascular and Vascular Surgery, CHU Rennes, Rennes, France. 5. University of Rennes, Inserm, UMR_1099, Rennes, France. 6. Département de Bactériologie-Virologie, Hygiène et Parasitologie-Mycologie, CHRU Brest, Brest, France. 7. Department of Bacteriology, CHU Rennes, Rennes, France. 8. University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR_1230, Rennes, France. 9. Infectious Diseases and Intensive Care Unit, CHU Rennes, Rennes, France. matthieu.revest@chu-rennes.fr. 10. University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR_1230, Rennes, France. matthieu.revest@chu-rennes.fr. 11. CIC-Inserm 1414, CHU Rennes, Rennes, France. matthieu.revest@chu-rennes.fr. 12. Service de Médecine Interne, Vasculaire et Pneumologie, Hôpital La Cavale Blanche, CHRU Brest, Brest, France. rozenn.leberre@chu-brest.fr. 13. Brest University, Inserm, UMR_1078, Brest, France. rozenn.leberre@chu-brest.fr.
Abstract
OBJECTIVES: Prosthetic vascular graft infection (PVGI) is a very severe disease. We aimed to determine the factors associated with treatment failure. METHODS: Patients admitted to two University Hospitals with PVGI were included in this retrospective study. PVGI was classified as possible, probable or proven according to an original set of diagnostic criteria. We defined treatment failure if one of the following events occurred within the first year after PVGI diagnosis: death and infection recurrence due to the same or another pathogen. RESULTS: One hundred and twelve patients were diagnosed with possible (n = 26), probable (n = 22) and proven (n = 64) PVGI. Bacterial documentation was obtained for 81% of patients. The most frequently identified pathogen was Staphylococcus aureus (n = 39). Surgery was performed in 96 patients (86%). Antibiotics were administered for more than 6 weeks in 41% of patients. Treatment failure occurred in 30 patients (27.5%). The factors associated with a lower probability of treatment failure were total removal of the infected graft (OR = 0.2, 95% CI [0.1-0.6]), rifampicin administration (OR = 0.3 [0.1-0.9]) and possible PVGI according to the GRIP criteria (OR = 0.3 [0.1-0.9]). CONCLUSIONS: Treatment failure occurred in 27.5% of patients with PVGI. Total removal of the infected graft and rifampicin administration were associated with better outcomes.
OBJECTIVES: Prosthetic vascular graft infection (PVGI) is a very severe disease. We aimed to determine the factors associated with treatment failure. METHODS:Patients admitted to two University Hospitals with PVGI were included in this retrospective study. PVGI was classified as possible, probable or proven according to an original set of diagnostic criteria. We defined treatment failure if one of the following events occurred within the first year after PVGI diagnosis: death and infection recurrence due to the same or another pathogen. RESULTS: One hundred and twelve patients were diagnosed with possible (n = 26), probable (n = 22) and proven (n = 64) PVGI. Bacterial documentation was obtained for 81% of patients. The most frequently identified pathogen was Staphylococcus aureus (n = 39). Surgery was performed in 96 patients (86%). Antibiotics were administered for more than 6 weeks in 41% of patients. Treatment failure occurred in 30 patients (27.5%). The factors associated with a lower probability of treatment failure were total removal of the infected graft (OR = 0.2, 95% CI [0.1-0.6]), rifampicin administration (OR = 0.3 [0.1-0.9]) and possible PVGI according to the GRIP criteria (OR = 0.3 [0.1-0.9]). CONCLUSIONS: Treatment failure occurred in 27.5% of patients with PVGI. Total removal of the infected graft and rifampicin administration were associated with better outcomes.