Prosthetic Joint Infections due to Candida Species: A Multicenter International Study

Aurelien Dinh; Martin McNally; Emma D'Anglejan; Christel Mamona Kilu; Julie Lourtet; Rosemary Ho; Matthew Scarborough; Maria Dudareva; Gerald Jesuthasan; Cecile Ronde Oustau; Stephane Klein; Laura Escola-Verge; Dolores Rodriguez Pardo; Pierre Delobel; Jaime Lora-Tamayo; Mikel Mancheno-Losa; Maria Luisa Sorli Redo; Jose Maria Barbero Allende; Cedric Arvieux; Danguole Vaznaisiene; Thomas Bauer; Anne-Laure Roux; Latifa Noussair; Stephane Corvec; Marta Fernandez-Sampedro; Nicolo Rossi; Adrien Lemaignen; Mauro Jose Costa Salles; Taiana Cunha Ribeiro; Julien Mazet; Milene Sasso; Jean-Philippe Lavigne; Albert Sotto; Etienne Canoui; Eric Senneville; Pauline Thill; Olivier Lortholary; Fanny Lanternier; Laura Morata; Alex Soriano; Gerard Giordano; Camille Fourcade; Bernhard J. H. Frank; Jochen G. Hofstaetter; Clara Duran; Eric Bonnet; European Soc Clinical Microbiol Infect Dis Study Grp Implant Associated

doi:10.1093/cid/ciae395

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Prosthetic Joint Infections due to Candida Species: A Multicenter International Study

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Prosthetic Joint Infections due to Candida Species: A Multicenter International Study

Aurelien Dinh, Martin McNally, Emma D'Anglejan, Christel Mamona Kilu, Julie Lourtet, Rosemary Ho, Matthew Scarborough, Maria Dudareva, Gerald Jesuthasan, Cecile Ronde Oustau, …

Clinical infectious diseases, Vol.80(2), pp.347-355

27/08/2024

DOI: https://doi.org/10.1093/cid/ciae395

PMID: 39189831

Résumé

Immunology

Infectious Diseases

Life Sciences & Biomedicine

Microbiology

Science & Technology

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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Titre: Prosthetic Joint Infections due to Candida Species: A Multicenter International Study
Créateurs - sans rôle: Aurelien Dinh - Paris Saclay Univ, Raymond Poincare Univ Hosp, Assistance Publ Hop Paris, Infect Dis Dept, Garches, France
Martin McNally - Oxford Univ Hosp, Nuffield Orthopaed Ctr, Oxford Bone Infect Unit, Oxford, England
Emma D'Anglejan - Paris Saclay Univ, Raymond Poincare Univ Hosp, Assistance Publ Hop Paris, Infect Dis Dept, Garches, France
Christel Mamona Kilu - Paris Saclay Univ, Raymond Poincare Univ Hosp, Assistance Publ Hop Paris, Infect Dis Dept, Garches, France
Julie Lourtet - St Joseph Hosp, Clin Microbiol Lab, Paris, France
Rosemary Ho - Oxford Univ Hosp, Nuffield Orthopaed Ctr, Oxford Bone Infect Unit, Oxford, England
Matthew Scarborough - Oxford Univ Hosp, Nuffield Orthopaed Ctr, Oxford Bone Infect Unit, Oxford, England
Maria Dudareva - Oxford Univ Hosp, Nuffield Orthopaed Ctr, Oxford Bone Infect Unit, Oxford, England
Gerald Jesuthasan - Oxford Univ Hosp, Nuffield Orthopaed Ctr, Oxford Bone Infect Unit, Oxford, England
Cecile Ronde Oustau - Strasbourg Univ Hosp, Orthoped Surg Dept, Strasbourg, France
Stephane Klein - Strasbourg Univ Hosp, Orthoped Surg Dept, Strasbourg, France
Laura Escola-Verge - Vall dHebron Univ Hosp, Infect Dis Dept, Barcelona, Spain
Dolores Rodriguez Pardo - Vall dHebron Univ Hosp, Infect Dis Dept, Barcelona, Spain
Pierre Delobel - Toulouse Univ Hosp, Infect Dis Dept, Toulouse, France
Jaime Lora-Tamayo - Hosp Univ 12 Octubre, Internal Med Dept, Madrid, Spain
Mikel Mancheno-Losa - Hosp Univ 12 Octubre, Internal Med Dept, Madrid, Spain
Maria Luisa Sorli Redo - Hosp del Mar, Infect Dis Dept, Barcelona, Spain
Jose Maria Barbero Allende - Hosp Univ Principe Asturias, Internal Med Dept, Alcala De Henares, Madrid, Spain
Cedric Arvieux - Université Rennes 1
Danguole Vaznaisiene - Lithuanian Univ Hlth Sci, Infect Dis Dept, Kaunas, Lithuania
Thomas Bauer - Paris Saclay Univ, Raymond Poincare Univ Hosp, Assistance Publ Hop Paris, Orthoped Surg Dept, Garches, France
Anne-Laure Roux - Paris Saclay Univ, Raymond Poincare Univ Hosp, Assistance Publ Hop Paris, Microbiol Dept, Garches, France
Latifa Noussair - Paris Saclay Univ, Raymond Poincare Univ Hosp, Assistance Publ Hop Paris, Microbiol Dept, Garches, France
Stephane Corvec - Nantes Univ Hosp, Infect Dis Dept, Nantes, France
Marta Fernandez-Sampedro - Marques de Valdecilla Hosp, Ctr Invest Biomed Red Enfermedades Infecciosas CI, Internal Med Dept, Inst Invest Sanitaria Valdecilla IDIVAL, Santander, Spain
Nicolo Rossi - St Orsola Polyclin, Orthoped Surg Dept, Bologna, Italy
Adrien Lemaignen - Bretonneau Univ Hosp, Infect Dis Dept, Tours, France
Mauro Jose Costa Salles - Fac Ciencias Med Santa Casa Sao Paulo, Infect Dis Dept, Sao Paulo, Brazil
Taiana Cunha Ribeiro - Fac Ciencias Med Santa Casa Sao Paulo, Infect Dis Dept, Sao Paulo, Brazil
Julien Mazet - Caremeau Univ Hosp, Infect Dis Dept, Nimes, France
Milene Sasso - Caremeau Univ Hosp, Infect Dis Dept, Nimes, France
Jean-Philippe Lavigne - Caremeau Univ Hosp, Infect Dis Dept, Nimes, France
Albert Sotto - Caremeau Univ Hosp, Infect Dis Dept, Nimes, France
Etienne Canoui - Cochin Univ Hosp, Assistance Publ Hop Paris, Infect Dis Dept, Paris, France
Eric Senneville - Lille Univ Hosp, Infect Dis Dept, Lille, France
Pauline Thill - Lille Univ Hosp, Infect Dis Dept, Lille, France
Olivier Lortholary - Necker Enfants Malad Univ Hosp, Assistance Publ Hop Paris, Necker Pasteur Ctr Infect Dis & Trop Med, Paris, France
Fanny Lanternier - Necker Enfants Malad Univ Hosp, Assistance Publ Hop Paris, Necker Pasteur Ctr Infect Dis & Trop Med, Paris, France
Laura Morata - Hosp Clin Barcelona, Infect Dis Dept, Barcelona, Spain
Alex Soriano - Hosp Clin Barcelona, Infect Dis Dept, Barcelona, Spain
Gerard Giordano - Joseph Ducuing Hosp, Orthoped Surg Dept, Toulouse, France
Camille Fourcade - Joseph Ducuing Hosp, Infect Dis Dept, Toulouse, France
Bernhard J. H. Frank - Orthopaed Hosp Vienna, Michael Ogon Lab Orthopaed Res, Speising, Austria
Jochen G. Hofstaetter - Orthopaed Hosp Vienna, Michael Ogon Lab Orthopaed Res, Speising, Austria
Clara Duran - Paris Saclay Univ, Raymond Poincare Univ Hosp, Assistance Publ Hop Paris, Infect Dis Dept, Garches, France
Eric Bonnet
European Soc Clinical Microbiol Infect Dis Study Grp Implant Associated
Détails de publication: Clinical infectious diseases, Vol.80(2), pp.347-355
Éditeur: Oxford Univ Press
Nombre de pages: 9
Identifiants: 99158623209311
Unité académique: Virulence Bacterienne et Infections Chroniques - VBIC
Langue: English
Type de ressource: Journal article