Fungal Prosthetic Joint Infection: A Case Series and Review of the Literature

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases and Therapy Pub Date : 2024-04-13 DOI:10.1007/s40121-024-00964-9

Victoria Starnes, Joan Duggan, Caitlyn Hollingshead

{"title":"Fungal Prosthetic Joint Infection: A Case Series and Review of the Literature","authors":"Victoria Starnes, Joan Duggan, Caitlyn Hollingshead","doi":"10.1007/s40121-024-00964-9","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Fungal prosthetic joint infections comprise less than 1% of prosthetic joint infections. Thus, little is known regarding optimal management. This study aims to characterize the microbiology, surgical and medical management, and outcomes for these complex infections. The objectives of this study were to assess the impact of surgical approach, antifungal treatment, fungal species, and time to onset of infection from initial surgery on patient outcomes.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A retrospective record review over 12 years was performed in two health systems that included patients with a deep culture positive for a fungal isolate and the presence of a prosthetic joint. A literature review was performed using the same inclusion criteria. A total of 289 cases were identified and analyzed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p><i>Candida</i> was the most common isolate, and a two-stage revision was the most commonly employed surgical modality<b>.</b> The type of surgical intervention had a statistically significant relationship with outcome (<i>P</i> = 0.022).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Two-stage revision with extended antifungal therapy is preferred in these infections due to higher rates of positive outcomes.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Diseases and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40121-024-00964-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Fungal prosthetic joint infections comprise less than 1% of prosthetic joint infections. Thus, little is known regarding optimal management. This study aims to characterize the microbiology, surgical and medical management, and outcomes for these complex infections. The objectives of this study were to assess the impact of surgical approach, antifungal treatment, fungal species, and time to onset of infection from initial surgery on patient outcomes.

Methods

A retrospective record review over 12 years was performed in two health systems that included patients with a deep culture positive for a fungal isolate and the presence of a prosthetic joint. A literature review was performed using the same inclusion criteria. A total of 289 cases were identified and analyzed.

Results

Candida was the most common isolate, and a two-stage revision was the most commonly employed surgical modality. The type of surgical intervention had a statistically significant relationship with outcome (P = 0.022).

Conclusions

Two-stage revision with extended antifungal therapy is preferred in these infections due to higher rates of positive outcomes.

Abstract Image

查看原文本刊更多论文

假关节真菌感染：病例系列和文献综述

导言真菌性假体关节感染在假体关节感染中所占比例不到 1%。因此，人们对最佳治疗方法知之甚少。本研究旨在了解这些复杂感染的微生物学特征、手术和内科治疗以及治疗效果。本研究的目的是评估手术方法、抗真菌治疗、真菌种类以及从初次手术到感染发生的时间对患者预后的影响。方法在两个医疗系统中对 12 年来的病历进行回顾性分析，其中包括真菌分离物深层培养呈阳性且存在人工关节的患者。采用相同的纳入标准进行了文献回顾。结果念珠菌是最常见的分离菌，两阶段翻修是最常用的手术方式。手术干预的类型与结果有显著的统计学关系（P = 0.022）。结论由于阳性结果率较高，在此类感染中首选两期翻修并延长抗真菌治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Infectious Diseases and Therapy Medicine-Microbiology (medical)

CiteScore

8.60

自引率

1.90%

发文量

136

审稿时长

6 weeks

期刊介绍： Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.