Prosthetic Shoulder Joint Infection by Cutibacterium acnes

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...

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Bibliographic Details
Authors: Vilchez, Helem|||0000-0002-4344-693X, Escudero Sánchez, Rosa|||0000-0001-5736-8111, Fernandez-Sampedro, Marta, Murillo Rubio, Oscar|||0000-0001-5776-8422, Auñón, Álvaro, Rodriguez-Pardo, Dolors|||0000-0001-6781-5405, Jover-Saenz, Alfredo|||0000-0001-5207-7200, del Toro López, María Dolores|||0000-0002-4935-8754, Rico Nieto, Alicia|||0000-0002-4364-2973, Falgueras, Luis, Praena-Segovia, Julia|||0000-0001-8138-0874, Guío, Laura, Iribarren, José Antonio, Lora-Tamayo, Jaime, Benito, Natividad|||0000-0001-6410-013X, Morata, Laura|||0000-0001-5795-0814, Ramírez Rosales, Antonio, Riera, Melchor
Format: article
Publication Date:2021
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:255503
Online Access:https://ddd.uab.cat/record/255503
https://dx.doi.org/urn:doi:10.3390/antibiotics10050475
Access Level:Open access
Keyword:Cutibacterium acnes
Prosthetic joint infection
Surgical and medical treatment
Description
Summary: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.

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