1. Outcome of patients with streptococcal prosthetic joint infections with special reference to rifampicin combinations
- Author
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V. Cattoir, B. Brunschweiler, E. Fiaux, Manuel Etienne, S. Nguyen, N. Frebourg, François Caron, J. P. Canarelli, J. Lora-Tamayo, Eric Senneville, F. Dujardin, Olivier Robineau, E. Beltrand, N. Blondiaux, Michel Valette, Marie Titecat, Henri Migaud, Caroline Loïez, Y. El Samad, C. Hulet, Inserm, Université de Lille, CHU Lille, Service des maladies infectieuses et tropicales [Rouen], Lille Inflammation Research International Center - U 995 [LIRIC], Centre Hospitalier Gustave Dron [Tourcoing], Hospital General Universitario 'Gregorio Marañón' [Madrid], CHU Amiens-Picardie, CHU Rouen, Université de Rouen Normandie [UNIROUEN], Université de Caen Normandie [UNICAEN], Université de Picardie Jules Verne [UPJV], Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab (ex-pmoi)], Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Microbiologie [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Rouen Normandie (UNIROUEN), Université de Caen Normandie (UNICAEN), Université de Picardie Jules Verne (UPJV), Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 (MABLab (ex-pmoi)), Université du Littoral Côte d'Opale (ULCO)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Thanks to Mr Philippe Choisy for technical assistance. J.L-T was supported by a grant from the Instituto de Salud Carlos III (Ministry of Economy and Competitiveness, Government of Spain, CD14/00176) and to Sharon Calandra for english editing., G4 bone and joint infection study group (G4BJIS)., and Université de Lille, LillOA
- Subjects
Male ,0301 basic medicine ,Prosthetic joint infection ,Knee Joint ,Levofloxacin ,Medical microbiology ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Mesh:Treatment Outcome ,Mesh:Knee Prosthesis/adverse effects ,Mesh:Humans ,Mesh:Knee Joint/microbiology ,Mesh:Middle Aged ,Mesh:Streptococcal Infections/etiology ,Mesh:Anti-Bacterial Agents/administration & dosage ,Mesh:Arthritis/drug therapy ,Mesh:Hip Prosthesis/microbiology ,Mesh:Prosthesis-Related Infections/drug therapy ,Mesh:Female ,Mesh:Knee Joint/surgery ,Mesh:Rifampin/administration & dosage ,Mesh:Male ,Mesh:Streptococcal Infections/drug therapy ,Mesh:Aged ,Mesh:Levofloxacin/administration & dosage ,Mesh:Drug Therapy ,Mesh:Combination ,Mesh:Arthroplasty ,Mesh:Replacement ,Mesh:Knee/adverse effects ,Mesh:Prosthesis-Related Infections/diagnosis ,Mesh:80 and over ,Mesh:Retrospective Studies ,Mesh:Hip Prosthesis/adverse effects ,Mesh:Knee Prosthesis/microbiology ,Outcome ,Rifampicin ,Streptococcus spp ,Risk factors ,Arthroplasty, Replacement, Knee ,10. No inequality ,Aged, 80 and over ,Middle Aged ,Anti-Bacterial Agents ,3. Good health ,Treatment Outcome ,Infectious Diseases ,[SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Drug Therapy, Combination ,Female ,Rifampin ,Knee Prosthesis ,Research Article ,medicine.drug ,musculoskeletal diseases ,medicine.medical_specialty ,Prosthesis-Related Infections ,Prosthetic joint ,030106 microbiology ,03 medical and health sciences ,Streptococcal Infections ,medicine ,Humans ,Aged ,Retrospective Studies ,business.industry ,Arthritis ,Surgery ,stomatognathic diseases ,Tropical medicine ,[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology ,Hip Prosthesis ,business - Abstract
International audience; Background: Outcome of patients with streptococcal prosthetic joint infections (PJIs) is not well known.Methods: We performed a retrospective multicenter cohort study that involved patients with total hip/knee prosthetic joint (THP/TKP) infections due to Streptococcus spp. from 2001 through 2009.Results: Ninety-five streptococcal PJI episodes (50 THP and 45 TKP) in 87 patients of mean age 69.1 ± 13.7 years met the inclusion criteria. In all, 55 out of 95 cases (57.9 %) were treated with debridement and retention of the infected implants with antibiotic therapy (DAIR). Rifampicin-combinations, including with levofloxacin, were used in 52 (54.7 %) and 28 (29.5 %) cases, respectively. After a mean follow-up period of 895 days (IQR: 395–1649), the remission rate was 70.5 % (67/95). Patients with PJIs due to S. agalactiae failed in the same proportion as in the other patients (10/37 (27.1 %) versus 19/58 (32.7 %); p = .55). In the univariate analysis, antibiotic monotherapy, DAIR, antibiotic treatments other than rifampicin-combinations, and TKP were all associated with a worse outcome. The only independent variable significantly associated with the patients’ outcomes was the location of the prosthesis (i.e., hip versus knee) (OR = 0.19; 95 % CI 0.04–0.93; p value 0.04).Conclusions: The prognosis of streptococcal PJIs may not be as good as previously reported, especially for patients with an infected total knee arthroplasty. Rifampicin combinations, especially with levofloxacin, appear to be suitable antibiotic regimens for these patients.
- Published
- 2016
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