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Factors related to outcome of early and delayed prosthetic joint infections

Ascione, T ; Pagliano, P ; Mariconda, M ; Rotondo, R ; Balato, G ; Toro, A ; Barletta, V ; Conte, M ; Esposito, S

The Journal of infection, 2015-01, Vol.70 (1), p.30-36 [Periódico revisado por pares]

England: Elsevier Ltd

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Título:
Factors related to outcome of early and delayed prosthetic joint infections
Autor: Ascione, T ; Pagliano, P ; Mariconda, M ; Rotondo, R ; Balato, G ; Toro, A ; Barletta, V ; Conte, M ; Esposito, S
Assuntos: Aged ; Aged, 80 and over ; Anti-Bacterial Agents - therapeutic use ; Comorbidity ; Cross Infection - diagnosis ; Cross Infection - microbiology ; Cross Infection - therapy ; Debridement ; Diagnosis ; Female ; Gram-Negative Bacterial Infections - diagnosis ; Gram-Negative Bacterial Infections - therapy ; Gram-Positive Bacterial Infections - diagnosis ; Gram-Positive Bacterial Infections - therapy ; Humans ; Infection ; Infectious Disease ; Italy - epidemiology ; Joint Prosthesis - adverse effects ; Joint Prosthesis - microbiology ; Kaplan-Meier Estimate ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Prospective Studies ; Prosthesis-Related Infections - diagnosis ; Prosthesis-Related Infections - epidemiology ; Prosthesis-Related Infections - therapy ; Prosthetic joint infections ; Surgical implant ; Synovial Fluid - microbiology ; Treatment ; Treatment Outcome
É parte de: The Journal of infection, 2015-01, Vol.70 (1), p.30-36
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SourceType-Scholarly Journals-1
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Descrição: Summary In this prospective study, we evaluate the impact of adherence to a diagnostic and therapeutic protocol on prosthetic joint infections (PJI) diagnostic accuracy and outcome. Patients and methods Patients with early or delayed PJI referred over a 5-year period were included. Diagnosis was based on characteristic clinical signs, radiographic findings and microbiological evidence. Antibiotics were chosen on the basis of microbiological findings, and drugs active against methicillin-resistant staphylococci were administered if no microbiological evidence had been obtained. Results Inclusion criteria were met in 159 cases (median age 64 years, males 45%). 56 were early infections and 103 delayed infections. Comorbidities were reported in 99 (62%) cases. Positive cultures were obtained in 122/159 (77%), coagulase-negative staphylococci were cultured in 20%, Staphylococcus aureus in 28%, and Pseudomonas aeruginosa in 7%. In early infections, cure rate after debridement and antibiotic therapy was 80%. In delayed infections, cure rate after two-stage exchange was 85%. Of 28 patients with delayed infection treated with antibiotics without surgery, only 8 (29%) infections were suppressed 48 weeks after treatment discontinuation. Rifampin afforded a better outcome. Conclusion Appropriate diagnostic and surgical procedures and microbiologically driven antibiotic therapy including rifampin are recommended to improve diagnostic accuracy and outcome.
Editor: England: Elsevier Ltd
Idioma: Inglês

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Factors related to outcome of early and delayed prosthetic joint infections

Ascione, T ; Pagliano, P ; Mariconda, M ; Rotondo, R ; Balato, G ; Toro, A ; Barletta, V ; Conte, M ; Esposito, S

England: Elsevier Ltd

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