Use of rifampicin and graft removal are associated with better outcomes in prosthetic vascular graft infection

被引:7
|
作者
Coste, Anne [1 ]
Poinot, Melanie [2 ]
Panaget, Sophie [1 ]
Albert, Benedicte [3 ]
Kaladji, Adrien [4 ,5 ]
Le Bars, Herve [6 ]
Bahaa, Nasr [3 ]
Ali, Badra [3 ]
Piau, Caroline [7 ]
Cattoir, Vincent [7 ,8 ]
de Moreuil, Claire [1 ]
Revest, Matthieu [2 ,8 ,9 ]
Le Berre, Rozenn [1 ,10 ]
机构
[1] CHRU Brest, Hop La Cavale Blanche, Serv Med Interne Vasc & Pneumol, Brest, France
[2] CHU Rennes, Infect Dis & Intens Care Unit, Rennes, France
[3] CHRU Brest, Serv Chirurg Cardiaque Thorac & Vasc, Brest, France
[4] CHU Rennes, Ctr Cardiovasc & Vasc Surg, Rennes, France
[5] Univ Rennes, INSERM, UMR 1099, Rennes, France
[6] CHRU Brest, Dept Bacteriol Virol Hyg & Parasitol Mycol, Brest, France
[7] CHU Rennes, Dept Bacteriol, Rennes, France
[8] Univ Rennes, INSERM, BRM Bacterial Regulatory RNAs & Med, UMR 1230, Rennes, France
[9] CHU Rennes, INSERM, CIC 1414, Rennes, France
[10] Brest Univ, INSERM, UMR 1078, Brest, France
关键词
Vascular prosthesis infection; Staphylococcus aureus; Rifampicin; ABDOMINAL AORTIC GRAFTS; STAPHYLOCOCCUS-AUREUS; MANAGEMENT; DIAGNOSIS; METAANALYSIS; THERAPY; FAILURE;
D O I
10.1007/s15010-020-01551-z
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives Prosthetic vascular graft infection (PVGI) is a very severe disease. We aimed to determine the factors associated with treatment failure. Methods Patients admitted to two University Hospitals with PVGI were included in this retrospective study. PVGI was classified as possible, probable or proven according to an original set of diagnostic criteria. We defined treatment failure if one of the following events occurred within the first year after PVGI diagnosis: death and infection recurrence due to the same or another pathogen. Results One hundred and twelve patients were diagnosed with possible (n = 26), probable (n = 22) and proven (n = 64) PVGI. Bacterial documentation was obtained for 81% of patients. The most frequently identified pathogen was Staphylococcus aureus (n = 39). Surgery was performed in 96 patients (86%). Antibiotics were administered for more than 6 weeks in 41% of patients. Treatment failure occurred in 30 patients (27.5%). The factors associated with a lower probability of treatment failure were total removal of the infected graft (OR = 0.2, 95% CI [0.1-0.6]), rifampicin administration (OR = 0.3 [0.1-0.9]) and possible PVGI according to the GRIP criteria (OR = 0.3 [0.1-0.9]). Conclusions Treatment failure occurred in 27.5% of patients with PVGI. Total removal of the infected graft and rifampicin administration were associated with better outcomes.
引用
收藏
页码:127 / 133
页数:7
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