2026-04-17T03:47:27Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/127412025-10-24T10:29:13Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Dinh, Aurélien author McNally, Martin author D’Anglejan, Emma author Mamona Kilu, Christel author LOURTET HASCOET, JULIE author Ho, Rosemary author Escolà-Vergé, Laura author Rodríguez Pardo, Ma Dolores author 2025-03-11T10:57:06Z 2025-03-11T10:57:06Z 2024 2025-02-15 Candida spp; Echinocandins; Prosthetic joint infection Candida spp; Equinocandines; Infecció de pròtesi articular Candida spp; Equinocandinas; Infección de prótesis articular Background Prosthetic joint infection (PJI) caused by Candida spp is a severe complication of arthroplasty. We investigated the outcomes of Candida PJI. Methods This was a retrospective observational multinational study including patients diagnosed with Candida-related PJI between 2010 and 2021. Treatment outcome was assessed at 2-year follow-up. Results A total of 269 patients were analyzed. Median age was 73.0 (interquartile range [IQR], 64.0–79.0) years; 46.5% of patients were male and 10.8% were immunosuppressed. Main infection sites were hip (53.0%) and knee (43.1%), and 33.8% patients had fistulas. Surgical procedures included debridement, antibiotics, and implant retention (DAIR) (35.7%), 1-stage exchange (28.3%), and 2-stage exchange (29.0%). Candida spp identified were Candida albicans (55.8%), Candida parapsilosis (29.4%), Candida glabrata (7.8%), and Candida tropicalis (5.6%). Coinfection with bacteria was found in 51.3% of cases. The primary antifungal agents prescribed were azoles (75.8%) and echinocandins (30.9%), administered for a median of 92.0 (IQR, 54.5–181.3) days. Cure was observed in 156 of 269 (58.0%) cases. Treatment failure was associated with age >70 years (OR, 1.811 [95% confidence interval {CI}: 1.079–3.072]), and the use of DAIR (OR, 1.946 [95% CI: 1.157–3.285]). Candida parapsilosis infection was associated with better outcome (OR, 0.546 [95% CI: .305–.958]). Cure rates were significantly different between DAIR versus 1-stage exchange (46.9% vs 67.1%, P = .008) and DAIR versus 2-stage exchange (46.9% vs 69.2%, P = .003), but there was no difference comparing 1- to 2-stage exchanges (P = .777). Conclusions Candida PJI prognosis seems poor, with high rate of failure, which does not appear to be linked to immunosuppression, use of azoles, or treatment duration. http://hdl.handle.net/11351/12741 Avaluació de resultats (Assistència sanitària) Articulacions artificials Candidiasi Medicaments antifúngics - Ús terapèutic DISEASES::Bacterial Infections and Mycoses::Infection::Prosthesis-Related Infections CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antifungal Agents Other subheadings::Other subheadings::/therapeutic use ORGANISMS::Eukaryota::Fungi::Ascomycota::Saccharomycetales::Candida ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Debridement ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones relacionadas con prótesis COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antifúngicos Otros calificadores::Otros calificadores::/uso terapéutico ORGANISMOS::Eukaryota::hongos::Ascomycota::Saccharomycetales::Candida TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::desbridamiento TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento Prosthetic Joint Infections due to Candida Species: A Multicenter International Study