Prosthetic Joint Infections due to Candida Species: A Multicenter International Study
- Type de publi. : Article dans une revue
- Date de publi. : 27/08/2024
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Auteurs :
Aurélien DinhMartin McnallyEmma D’anglejanChristel Mamona KiluJulie LourtetRosemary HoMatthew ScarboroughMaria DudarevaGerald JesuthasanCecile Ronde OustauStéphane KleinLaura Escolà-VergéDolores Rodriguez PardoPierre DelobelJaime Lora-TamayoMikel Mancheño-LosaMaria Luisa Sorlí RedóJosé María Barbero AllendeCédric ArvieuxDanguole VaznaisièneThomas BauerAnne-Laure RouxLatifa NoussairStéphane CorvecMarta Fernández-SampedroNicolò RossiAdrien LemaignenMauro José Costa SallesTaiana Cunha RibeiroJulien MazetMilène SassoJean-Philippe LavigneAlbert SottoEtienne CanouïÉric SennevillePauline ThillOlivier LortholaryFanny LanternierLaura MorataAlex SorianoGérard GiordanoCamille FourcadeBernhard J H FrankJochen G HofstaetterClara DuranEric Bonnet
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Organismes :
Hôpital Raymond Poincaré [AP-HP]
Oxford University Hospitals NHS Trust
Hôpital Raymond Poincaré [AP-HP]
Hôpital Raymond Poincaré [AP-HP]
Groupe Hospitalier Paris Saint-Joseph
Oxford University Hospitals NHS Trust
Oxford University Hospitals NHS Trust
Oxford University Hospitals NHS Trust
Oxford University Hospitals NHS Trust
Université de Strasbourg
Université de Strasbourg
Vall d'Hebron University Hospital [Barcelona]
Vall d'Hebron University Hospital [Barcelona]
Centre Hospitalier Universitaire de Toulouse
Hospital Universitario 12 de Octubre [Madrid]
Hospital Universitario 12 de Octubre [Madrid]
Hospital Universitario Puerta del Mar [Cádiz, Spain]
Universidad de Alcalá [Alcalá de Henares, España] = University of Alcalá [Alcalá de Henares, Spain] = Université d'Alcalá [Alcalá de Henares, Espagne]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Lithuanian University of health Sciences
Hôpital Raymond Poincaré [AP-HP]
Hôpital Raymond Poincaré [AP-HP]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
Marqués de Valdecilla Research Institute - Instituto de Investigación Marqués de Valdecilla [Santander]
Hôpital Bretonneau
Faculdade de Ciências Médicas Santa Casa de São Paulo [Brazil]
Faculdade de Ciências Médicas Santa Casa de São Paulo [Brazil]
Centre Hospitalier Universitaire de Nîmes
Centre Hospitalier Universitaire de Nîmes
Centre Hospitalier Universitaire de Nîmes
Centre Hospitalier Universitaire de Nîmes
Hôpital Cochin [AP-HP]
Centre Hospitalier Régional Universitaire [CHU Lille]
Centre Hospitalier Régional Universitaire [CHU Lille]
Hôpital Necker - Enfants Malades [AP-HP]
Hôpital Necker - Enfants Malades [AP-HP]
Hôpital Joseph Ducuing - Varsovie [Toulouse]
Hôpital Joseph Ducuing - Varsovie [Toulouse]
Wilhelminenspital Vienna = Wilhelminen Hospital
Wilhelminenspital Vienna = Wilhelminen Hospital
Hôpital Raymond Poincaré [AP-HP]
Hôpital Joseph Ducuing - Varsovie [Toulouse]
- Publié dans Clinical Infectious Diseases le 30/10/2020
Résumé : Background: Prosthetic joint infection (PJI) caused by Candida spp is a severe complication of arthroplasty. We investigated the outcomes of Candida PJI. Methods: This was a retrospective observational multinational study including patients diagnosed with Candida-related PJI between 2010 and 2021. Treatment outcome was assessed at 2-year follow-up. Results: A total of 269 patients were analyzed. Median age was 73.0 (interquartile range [IQR], 64.0-79.0) years; 46.5% of patients were male and 10.8% were immunosuppressed. Main infection sites were hip (53.0%) and knee (43.1%), and 33.8% patients had fistulas. Surgical procedures included debridement, antibiotics, and implant retention (DAIR) (35.7%), 1-stage exchange (28.3%), and 2-stage exchange (29.0%). Candida spp identified were Candida albicans (55.8%), Candida parapsilosis (29.4%), Candida glabrata (7.8%), and Candida tropicalis (5.6%). Coinfection with bacteria was found in 51.3% of cases. The primary antifungal agents prescribed were azoles (75.8%) and echinocandins (30.9%), administered for a median of 92.0 (IQR, 54.5-181.3) days. Cure was observed in 156 of 269 (58.0%) cases. Treatment failure was associated with age >70 years (OR, 1.811 [95% confidence interval {CI}: 1.079-3.072]), and the use of DAIR (OR, 1.946 [95% CI: 1.157-3.285]). Candida parapsilosis infection was associated with better outcome (OR, 0.546 [95% CI: .305-.958]). Cure rates were significantly different between DAIR versus 1-stage exchange (46.9% vs 67.1%, P = .008) and DAIR versus 2-stage exchange (46.9% vs 69.2%, P = .003), but there was no difference comparing 1- to 2-stage exchanges (P = .777). Conclusions: Candida PJI prognosis seems poor, with high rate of failure, which does not appear to be linked to immunosuppression, use of azoles, or treatment duration.
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