دورية أكاديمية
أعرض في EDS

The Microbiological Etiology of Fracture-Related Infection.

التفاصيل البيبلوغرافية
العنوان: The Microbiological Etiology of Fracture-Related Infection.
المؤلفون: Depypere M; Department of laboratory medicine, University Hospitals Leuven, Leuven, Belgium.; Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Bacteriology and Mycology, KU Leuven, Leuven, Belgium., Sliepen J; Department of Trauma Surgery, University Medical Center Groningen, Groningen, Netherlands., Onsea J; Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium.; Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium., Debaveye Y; Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium., Govaert GAM; Department of Trauma Surgery, University of Utrecht, University Medical Center Utrecht, Utrecht, Netherlands., IJpma FFA; Department of Trauma Surgery, University Medical Center Groningen, Groningen, Netherlands., Zimmerli W; Basel University Medical Clinic, Kantonsspital Baselland, Liestal, Switzerland., Metsemakers WJ; Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium.; Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.
المصدر: Frontiers in cellular and infection microbiology [Front Cell Infect Microbiol] 2022 Jul 07; Vol. 12, pp. 934485. Date of Electronic Publication: 2022 Jul 07 (Print Publication: 2022).
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Frontiers Media SA Country of Publication: Switzerland NLM ID: 101585359 Publication Model: eCollection Cited Medium: Internet ISSN: 2235-2988 (Electronic) Linking ISSN: 22352988 NLM ISO Abbreviation: Front Cell Infect Microbiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Lausanne : Frontiers Media SA
مواضيع طبية MeSH: Coinfection*/drug therapy, Anti-Bacterial Agents/therapeutic use ; Gram-Negative Bacteria ; Humans ; Microbial Sensitivity Tests ; Prospective Studies ; Retrospective Studies ; Staphylococcus epidermidis
مستخلص: Purpose: Fracture-related infection (FRI) is an important complication related to orthopaedic trauma. Although the scientific interest with respect to the diagnosis and treatment of FRI is increasing, data on the microbiological epidemiology remains limited. Therefore, the primary aim of this study was to evaluate the microbiological epidemiology related to FRI, including the association with clinical symptoms and antimicrobial susceptibility data. The secondary aim was to analyze whether there was a relationship between the time to onset of infection and the microbiological etiology of FRI.
Methods: FRI patients treated at the University Hospitals of Leuven, Belgium, between January 1st 2015 and November 24th 2019 were evaluated retrospectively. The microbiological etiology and antimicrobial susceptibility data were analyzed. Patients were classified as having an early (<2 weeks after implantation), delayed (2-10 weeks) or late-onset (> 10 weeks) FRI.
Results: One hundred ninety-one patients with 194 FRIs, most frequently involving the tibia (23.7%) and femur (18.6%), were included. Staphylococcus aureus was the most frequently isolated pathogen, regardless of time to onset (n=61; 31.4%), followed by S. epidermidis (n=50; 25.8%) and non- epidermidis coagulase-negative staphylococci (n=35; 18.0%). Polymicrobial infections (n=49; 25.3%), mainly involving Gram negative bacilli (GNB) (n=32; 65.3%), were less common than monomicrobial infections (n=138; 71.1%). Virulent pathogens in monomicrobial FRIs were more likely to cause pus or purulent discharge (n=45;54.9%; p=0.002) and fistulas (n=21;25.6%; p=0.030). Susceptibility to piperacillin/tazobactam for GNB was 75.9%. Vancomycin covered 100% of Gram positive cocci.
Conclusion: This study revealed that in early FRIs, polymicrobial infections and infections including Enterobacterales and enterococcal species were more frequent. A time-based FRI classification is not meaningful to estimate the microbiological epidemiology and cannot be used to guide empiric antibiotic therapy. Large multicenter prospective studies are necessary to gain more insight into the added value of (broad) empirical antibiotic therapy.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2022 Depypere, Sliepen, Onsea, Debaveye, Govaert, IJpma, Zimmerli and Metsemakers.)
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فهرسة مساهمة: Keywords: antibiotic resistance; fracture; fracture-related infection; infection; microbiology
المشرفين على المادة: 0 (Anti-Bacterial Agents)
تواريخ الأحداث: Date Created: 20220725 Date Completed: 20220726 Latest Revision: 20220920
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9300981
DOI: 10.3389/fcimb.2022.934485
PMID: 35873162
قاعدة البيانات: MEDLINE
الوصف
تدمد:2235-2988
DOI:10.3389/fcimb.2022.934485