What Is the Success of Treatment of Hip and Knee Candidal Periprosthetic Joint Infection?

详细信息    查看全文

• 作者：Steve W. N. Ueng MD (1) (2)
  Ching-Yu Lee MD (3)
  Chih-chien Hu MD (1) (2)
  Pang-Hsin Hsieh MD (1) (2)
  Yuhan Chang MD ; PhD (1) (2)
  
• 刊名：Clinical Orthopaedics and Related Research?
• 出版年：2013
• 出版时间：September 2013
• 年：2013
• 卷：471
• 期：9
• 页码：3002-3009
• 全文大小：272KB
• 参考文献：1. Anagnostakos K, Kelm J, Schmitt E, Jung J. Fungal periprosthetic hip and knee joint infections: clinical experience with a 2-stage treatment protocol. / J Arthroplasty. 2012;27:293-98. CrossRef
  2. Anaissie EJ, Darouiche RO, Abi-Said D, Uzun O, Mera J, Gentry LO, Williams T, Kontoyiannis DP, Karl CL, Bodey GP. Management of invasive candidal infections: results of a prospective, randomized, multicenter study of fluconazole versus amphotericin B and review of the literature. / Clin Infect Dis. 1996;23:964-72. CrossRef
  3. Azzam K, Parvizi J, Jungkind D, Hanssen A, Fehring T, Springer B, Bozic K, Della Valle C, Pulido L, Barrack R. Microbiological, clinical, and surgical features of fungal prosthetic joint infections: a multi-institutional experience. / J Bone Joint Surg Am. 2009;91(suppl 6):142-49. CrossRef
  4. Brooks DH, Pupparo F. Successful salvage of a primary total knee arthroplasty infected with Candida parapsilosis. / J Arthroplasty. 1998;13:707-12. CrossRef
  5. Cui Q, Mihalko WM, Shields JS, Ries M, Saleh KJ. Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty. / J Bone Joint Surg Am. 2007;89:871-82. CrossRef
  6. Cushing RD, Fulgenzi WR. Synovial fluid levels of fluconazole in a patient with Candida parapsilosis prosthetic joint infection who had an excellent clinical response. / J Arthroplasty. 1997;12:950. CrossRef
  7. Debruyne D, Ryckelynck JP. Clinical pharmacokinetics of fluconazole. / Clin Pharmacokinet. 1993;24:10-7. CrossRef
  8. Esenwein SA, Robert K, Kollig E, Ambacher T, Kutscha-Lissberg F, Muhr G. [Long-term results after resection arthroplasty according to Girdlestone for treatment of persisting infections of the hip joint] [in German]. / Chirurg. 2001;72:1336-343. CrossRef
  9. Evans RP, Nelson CL. Staged reimplantation of a total hip prosthesis after infection with Candida albicans: a report of two cases. / J Bone Joint Surg Am. 1990;72:1551-553.
  10. Falahee MH, Matthews LS, Kaufer H. Resection arthroplasty as a salvage procedure for a knee with infection after a total arthroplasty. / J Bone Joint Surg Am. 1987;69:1013-021.
  11. Fisher MA, Shen SH, Haddad J, Tarry WF. Comparison of in vivo activity of fluconazole with that of amphotericin B against Candida tropicalis, Candida glabrata, and Candida krusei. / Antimicrob Agents Chemother. 1989;33:1443-446. CrossRef
  12. Fukasawa N, Shirakura K. Candida arthritis after total knee arthroplasty: a case of successful treatment without prosthesis removal. / Acta Orthop Scand. 1997;68:306-07. CrossRef
  13. Gaston G, Ogden J. Candida glabrata periprosthetic infection: a case report and literature review. / J Arthroplasty. 2004;19:927-30. CrossRef
  14. Goss B, Lutton C, Weinrauch P, Jabur M, Gillett G, Crawford R. Elution and mechanical properties of antifungal bone cement. / J Arthroplasty. 2007;22:902-08. CrossRef
  15. Grauer JD, Amstutz HC, O’Carroll PF, Dorey FJ. Resection arthroplasty of the hip. / J Bone Joint Surg Am. 1989;71:669-78.
  16. Graw B, Woolson S, Huddleston JI. Candida infection in total knee arthroplasty with successful reimplantation. / J Knee Surg. 2010; 23:169-74. CrossRef
  17. Insall JN, Thompson FM, Brause BD. Two-stage reimplantation for the salvage of infected total knee arthroplasty. / J Bone Joint Surg Am. 1983;65:1087-098.
  18. Levine M, Rehm SJ, Wilde AH. Infection with Candida albicans of a total knee arthroplasty: case report and review of the literature. / Clin Orthop Relat Res. 1988; 226:235-39.
  19. MacGregor RR, Schimmer BM, Steinberg ME. Results of combined amphotericin B-5-fluorcytosine therapy for prosthetic knee joint infected with Candida parapsilosis. / J Rheumatol. 1979;6:451-55.
  20. Malinzak RA, Ritter MA, Berend ME, Meding JB, Olberding EM, Davis KE. Morbidly obese, diabetic, younger, and unilateral joint arthroplasty patients have elevated total joint arthroplasty infection rates. / J Arthroplasty. 2009;24(6 suppl):84-8. CrossRef
  21. Merrer J, Dupont B, Nieszkowska A, De Jonghe B, Outin H. Candida albicans prosthetic arthritis treated with fluconazole alone. / J Infect. 2001;42:208-09. CrossRef
  22. Mittal Y, Fehring TK, Hanssen A, Marculescu C, Odum SM, Osmon D. Two-stage reimplantation for periprosthetic knee infection involving resistant organisms. / J Bone Joint Surg Am. 2007;89:1227-231. CrossRef
  23. Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, Edwards JE Jr, Filler SG, Fisher JF, Kullberg BJ, Ostrosky-Zeichner L, Reboli AC, Rex JH, Walsh TJ, Sobel JD; Infectious Diseases Society of America. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. / Clin Infect Dis. 2009;48:503-35. CrossRef
  24. Phelan DM, Osmon DR, Keating MR, Hanssen AD. Delayed reimplantation arthroplasty for candidal prosthetic joint infection: a report of 4 cases and review of the literature. / Clin Infect Dis. 2002;34:930-38. CrossRef
  25. Pour AE, Matar WY, Jafari SM, Purtill JJ, Austin MS, Parvizi J. Total joint arthroplasty in patients with hepatitis C. / J Bone Joint Surg Am. 2011;93:1448-454. CrossRef
  26. Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors. / Clin Orthop Relat Res. 2008;466:1710-715. CrossRef
  27. Shih LY, Cheng CY, Chang CH, Hsu KY, Hsu RW, Shih HN. Total knee arthroplasty in patients with liver cirrhosis. / J Bone Joint Surg Am. 2004;86:335-41.
  28. Simonian PT, Brause BD, Wickiewicz TL. Candida infection after total knee arthroplasty: management without resection or amphotericin B. / J Arthroplasty. 1997;12:825-29. CrossRef
  29. Toms AD, Davidson D, Masri BA, Duncan CP. The management of peri-prosthetic infection in total joint arthroplasty. / J Bone Joint Surg Br. 2006;88:149-55.
  30. Trofa D, Gacser A, Nosanchuk JD. Candida parapsilosis, an emerging fungal pathogen. / Clin Microbiol Rev. 2008;21:606-25. CrossRef
  31. Tsukayama DT, Estrada R, Gustilo RB. Infection after total hip arthroplasty: a study of the treatment of one hundred and six infections. / J Bone Joint Surg Am. 1996;78:512-23.
  32. Vince KG, Kantor SR, Descalzi J. Late infection of a total knee arthroplasty with Streptococcus bovis in association with carcinoma of the large intestine. / J Arthroplasty. 2003;18:813-15. CrossRef
  33. Weinberger M, Leibovici L, Perez S, Samra Z, Ostfeld I, Levi I, Bash E, Turner D, Goldschmied-Reouven A, Regev-Yochay G, Pitlik SD, Keller N. Characteristics of candidaemia with Candida-albicans compared with non-albicans Candida species and predictors of mortality. / J Hosp Infect. 2005;61:146-54. CrossRef
  34. Wheat J, Sarosi G, McKinsey D, Hamill R, Bradsher R, Johnson P, Loyd J, Kauffman C. Practice guidelines for the management of patients with histoplasmosis: Infectious Diseases Society of America. / Clin Infect Dis. 2000;30:688-95. CrossRef
  35. White A, Goetz MB. Candida parapsilosis prosthetic joint infection unresponsive to treatment with fluconazole. / Clin Infect Dis. 1995;20:1068-069. CrossRef
  36. Windsor RE, Insall JN, Urs WK, Miller DV, Brause BD. Two-stage reimplantation for the salvage of total knee arthroplasty complicated by infection: further follow-up and refinement of indications. / J Bone Joint Surg Am. 1990;72:272-78.
  37. Wu MH, Hsu KY. Candidal arthritis in revision knee arthroplasty successfully treated with sequential parenteral-oral fluconazole and amphotericin B-loaded cement spacer. / Knee Surg Sports Traumatol Arthrosc. 2011;19:273-76. CrossRef
  38. Wyman J, McGough R, Limbird R. Fungal infection of a total knee prosthesis: successful treatment using articulating cement spacers and staged reimplantation. / Orthopedics. 2002;25:1391-394; discussion 1394.
  39. Younkin S, Evarts CM, Steigbigel RT. Candida parapsilosis infection of a total hip-joint replacement: successful reimplantation after treatment with amphotericin B and 5-fluorocytosine. A case report. / J Bone Joint Surg Am. 1984;66:142-43.
  
• 作者单位：Steve W. N. Ueng MD (1) (2)
  Ching-Yu Lee MD (3)
  Chih-chien Hu MD (1) (2)
  Pang-Hsin Hsieh MD (1) (2)
  Yuhan Chang MD, PhD (1) (2)
  
  1. Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsin St, Kweishan, Linkou, 333, Taiwan
  2. School of Medicine, Chang Gung University, Taoyuan, Taiwan
  3. Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
  

文摘

Background Fungal infection at an arthroplasty site is rare and poses a therapeutic challenge. To the best of our knowledge, no reports have been published thus far on the success rate of prosthesis reimplantation after fungal prosthetic joint infections. Questions/purposes We asked: (1) What is the success rate in terms of infection eradication using a two-stage exchange arthroplasty in patients with hip or knee fungal periprosthetic joint infections, particularly focusing on Candida infections? (2) What patient-, infection-, and treatment-related variables are associated with the success or failure of treatment? Methods From January 2000 to December 2010, 16 patients with hip or knee candidal periprosthetic joint infections were treated with two-stage exchange arthroplasty at our institute. Treatment success was defined as a well-functioning joint without relapse of candidal infection after prosthesis reimplantation, while treatment failure was defined as uncontrolled or relapse of candidal infection or mortality. Variables, including age, sex, comorbidities, microbiology, antimicrobial agents used, and operative methods, were analyzed. Minimum followup was 28?months (mean, 41?months; range, 28-0?months). Results At latest followup, the treatment failed to eradicate the infection in eight of the 16 patients, and there were four deaths related to fungemia. Four patients required permanent resection arthroplasty owing to uncontrolled or recurrent candidal infections. All eight patients (50% successful rate) who had their infections eradicated and successful prosthesis reimplantation had prolonged treatment with oral fluconazole before (mean, 8?months) and after (mean, 2.2?months) prosthesis reimplantation. The antifungal therapy correlated with successful treatment. Renal insufficiency, hypoalbuminemia, anemia, and chronic obstructive pulmonary disease were significantly more prevalent in the treatment-failure group than in the treatment-success group. Conclusions Half of the patients treated with two-stage exchange arthroplasty for fungal periprosthetic joint infections had recurrence or lack of control of the infection. A prolonged antifungal therapy appeared to be essential for successful treatment of candidal periprosthetic joint infections. The presence of renal insufficiency, hypoalbuminemia, anemia, or chronic obstructive pulmonary disease might be associated with a poor outcome. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.