000169354 001__ 169354
000169354 005__ 20260225105429.0
000169354 0247_ $$2doi$$a10.1111/j.1469-0691.2010.03157.x
000169354 0248_ $$2sideral$$a147127
000169354 037__ $$aART-2010-147127
000169354 041__ $$aeng
000169354 100__ $$aRodríguez D
000169354 245__ $$aAcute haematogenous prosthetic joint infection: prospective evaluation of medical and surgical management
000169354 260__ $$c2010
000169354 5060_ $$aAccess copy available to the general public$$fUnrestricted
000169354 5203_ $$aThe optimum treatment for prosthetic joint infections has not been clearly defined. We report our experience of the management of acute haematogenous prosthetic joint infection (AHPJI) in patients during a 3-year prospective study in nine Spanish hospitals. Fifty patients, of whom 30 (60%) were female, with a median age of 76 years, were diagnosed with AHPJI. The median infection-free period following joint replacement was 4.9 years. Symptoms were acute in all cases. A distant previous infection and/or bacteraemia were identified in 48%. The aetiology was as follows: Staphylococcus aureus, 19; Streptococcus spp., 14; Gram-negative bacilli, 12; anaerobes, two; and mixed infections, three. Thirty-four (68%) patients were treated with a conservative surgical approach (CSA) with implant retention, and 16 had prosthesis removal. At 2-year follow-up, 24 (48%) were cured, seven (14%) had relapsed, seven (14%) had died, five (10%) had persistent infection, five had re-infection, and two had an unknown evolution. Overall, the treatment failure rates were 57.8% in staphylococcal infections and 14.3% in streptococcal infections. There were no failures in patients with Gram-negative bacillary. By multivariate analysis, CSA was the only factor independently associated with treatment failure (OR 11.6; 95% CI 1.29–104.8). We were unable to identify any factors predicting treatment failure in CSA patients, although a Gram-negative bacillary aetiology was a protective factor. These data suggest that although conservative surgery was the only factor independently associated with treatment failure, it could be the first therapeutic choice for the management of Gram-negative bacillary and streptococcal AHPJI, and for some cases with acute S. aureus infections.
000169354 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
000169354 590__ $$a4.784$$b2010
000169354 591__ $$aMICROBIOLOGY$$b17 / 103 = 0.165$$c2010$$dQ1$$eT1
000169354 591__ $$aINFECTIOUS DISEASES$$b8 / 57 = 0.14$$c2010$$dQ1$$eT1
000169354 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000169354 700__ $$aPigrau C
000169354 700__ $$aEuba G
000169354 700__ $$aCobo J
000169354 700__ $$0(orcid)0000-0002-9582-5472$$aGarcía-Lechuz J$$uUniversidad de Zaragoza
000169354 700__ $$aPalomino J
000169354 700__ $$aAriza J
000169354 700__ $$aSoriano A
000169354 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000169354 773__ $$g16, 12 (2010), 1789-1795$$pClin. microbiol. infect.$$tClinical Microbiology and Infection$$x1198-743X
000169354 8564_ $$s478619$$uhttps://zaguan.unizar.es/record/169354/files/texto_completo.pdf$$yPostprint
000169354 8564_ $$s2168817$$uhttps://zaguan.unizar.es/record/169354/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000169354 909CO $$ooai:zaguan.unizar.es:169354$$particulos$$pdriver
000169354 951__ $$a2026-02-24-14:47:22
000169354 980__ $$aARTICLE