Title:
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Prosthetic Shoulder Joint Infection by Cutibacterium acnes : Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study
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Author:
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Vilchez, Helem; Escudero-Sánchez, Rosa; Fernandez-Sampedro, Marta; Murillo Rubio, Oscar; Auñón, Álvaro; Rodriguez-Pardo, Dolors; Jover-Sáenz, Alfredo; del Toro López, María Dolores; Rico Nieto, Alicia; Falgueras, Luis; Praena-Segovia, Julia; Guío, Laura; Iribarren, José A.; Lora-Tamayo, Jaime; Benito, Natividad; Morata, Laura; Ramírez Rosales, Antonio; Riera, Melchor; Universitat Autònoma de Barcelona
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Abstract:
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This retrospective, multicenter observational study aimed to describe the outcomes of surgical and medical treatment of C. acnes -related prosthetic joint infection (PJI) and the potential benefit of rifampin-based therapies. Patients with C. acnes -related PJI who were diagnosed and treated between January 2003 and December 2016 were included. We analyzed 44 patients with C. acnes -related PJI (median age, 67.5 years (IQR, 57.3-75.8)); 75% were men. The majority (61.4%) had late chronic infection according to the Tsukayama classification. All patients received surgical treatment, and most antibiotic regimens (43.2%) included β-lactam. Thirty-four patients (87.17%) were cured; five showed relapse. The final outcome (cure vs. relapse) showed a nonsignificant trend toward higher failure frequency among patients with previous prosthesis (OR: 6.89; 95% CI: 0.80-58.90) or prior surgery and infection (OR: 10.67; 95% IC: 1.08-105.28) in the same joint. Patients treated with clindamycin alone had a higher recurrence rate (40.0% vs. 8.8%). Rifampin treatment did not decrease recurrence in patients treated with β-lactams. Prior prosthesis, surgery, or infection in the same joint might be related to recurrence, and rifampin-based combinations do not seem to improve prognosis. Debridement and implant retention appear a safe option for surgical treatment of early PJI. |
Subject(s):
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-Cutibacterium acnes -Prosthetic joint infection -Surgical and medical treatment |
Rights:
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open access
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https://creativecommons.org/licenses/by/4.0/ |
Document type:
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Article |
Published by:
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Share:
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Uri:
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https://ddd.uab.cat/record/255503
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