A novel case of prosthetic joint infection due to Clostridioides difficile successfully suppressed with oral doxycycline.

Access microbiology Pub Date : 2025-09-19 eCollection Date: 2025-01-01 DOI:10.1099/acmi.0.000943.v3
Holly Jordan, Rikki Graham, Sanmarie Schlebusch, Aileen Oon, Hemalatha Varadhan, Syeda Naqvi
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引用次数: 0

Abstract

Extra-colonic infections caused by Clostridioides difficile are exceptionally rare, with prosthetic joint infections (PJIs) comprising only a small fraction of the reported cases. Moreover, there is limited guidance on the optimal management of such infections. We present the case of a 76-year-old man who developed a left hip PJI due to C. difficile 6 weeks after undergoing surgical revision for a periprosthetic fracture. Given the complexity of the case, curative surgical intervention was not considered feasible. The patient was treated with repeated debridement, intravenous vancomycin and oral (PO) metronidazole, followed by successful suppression with PO doxycycline - a novel therapeutic approach not previously documented. To date, only seven cases of C. difficile-associated PJI have been reported in the literature; this is the first known instance in which suppression of a C. difficile PJI has been achieved and the first to utilize whole-genome sequencing for further analysis of the isolate.

口服强力霉素成功抑制难辨梭菌引起的假体关节感染一例。
艰难梭菌引起的结肠外感染非常罕见,假体关节感染(PJIs)仅占报告病例的一小部分。此外,对此类感染的最佳管理指导有限。我们报告了一位76岁的男性患者,他在接受假体周围骨折手术翻修后6周因艰难梭菌感染出现左髋关节PJI。鉴于病例的复杂性,治疗性手术干预不被认为是可行的。患者接受反复清创、静脉注射万古霉素和口服甲硝唑治疗,随后用强力霉素成功抑制,这是一种以前没有文献记载的新型治疗方法。迄今为止,文献中仅报道了7例艰难梭菌相关PJI;这是已知的第一个抑制艰难梭菌PJI的例子,也是第一个利用全基因组测序对分离物进行进一步分析的例子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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