Intraoperative Bacterial Contamination and Activity of Different Antimicrobial Prophylaxis Regimens in Primary Knee and Hip Replacement

Autor: Rivera, Alba, Sánchez, Alba, Luque Pardos, Sònia, Mur, Isabel, Puig, Lluís, Crusi, Xavier, González, José Carlos, Sorli Redó, M. Luisa, González, Aránzazu, Horcajada Gallego, Juan Pablo, Navarro, Ferran, Benito, Natividad
Jazyk: angličtina
Rok vydání: 2021
Předmět:
musculoskeletal diseases
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Prosthetic joint infection
medicine.medical_treatment
030106 microbiology
Cefazolin
Antibiotic levels
knee arthroplasty
surgical antimicrobial prophylaxis
Biochemistry
Microbiology
Prosthetic joint infection prevention
Article
Intraoperative cultures
03 medical and health sciences
0302 clinical medicine
Internal medicine
Hip replacement
Serum bactericidal titer
medicine
Surgical antimicrobial prophylaxis
surgical site infection prevention
Pharmacology (medical)
General Pharmacology
Toxicology and Pharmaceutics
prosthetic joint infection
hip arthroplasty
030222 orthopedics
intraoperative cultures
prosthetic joint infection prevention
business.industry
lcsh:RM1-950
Surgical wound
antibiotic levels
Antimicrobial
Arthroplasty
Knee arthroplasty
Surgical site infection prevention
Infectious Diseases
lcsh:Therapeutics. Pharmacology
Vancomycin
Hip arthroplasty
Gentamicin
serum bactericidal titer
business
Cefuroxime
medicine.drug
Zdroj: Antibiotics-Basel
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
Fundacion Sancho el Sabio Fundazioa (FSS)
Antibiotics, Vol 10, Iss 18, p 18 (2021)
Antibiotics
Volume 10
Issue 1
Dipòsit Digital de Documents de la UAB
Universitat Autònoma de Barcelona
ISSN: 2079-6382
Popis: Surgical antimicrobial prophylaxis (SAP) is important for the prevention of prosthetic joint infections (PJIs) and must be effective against the microorganisms most likely to contaminate the surgical site. Our aim was to compare different SAP regimens (cefazolin, cefuroxime, or vancomycin, alone or combined with gentamicin) in patients undergoing total knee (TKA) and hip (THA) arthroplasty. In this preclinical exploratory analysis, we analyzed the results of intraoperative sample cultures, the ratio of plasma antibiotic levels to the minimum inhibitory concentrations (MICs) for bacteria isolated at the surgical wound and ATCC strains, and serum bactericidal titers (SBT) against the same microorganisms. A total of 132 surgical procedures (68 TKA, 64 THA) in 128 patients were included. Cultures were positive in 57 (43.2%) procedures (mostly for coagulase-negative staphylococci and Cutibacterium spp.)
the rate was lower in the group of patients receiving combination SAP (adjusted OR 0.475, CI95% 0.229&ndash
0.987). The SAP regimens evaluated achieved plasma levels above the MICs in almost all of intraoperative isolates (93/94, 98.9%) and showed bactericidal activity against all of them (SBT range 1:8&ndash
1:1024), although SBTs were higher in patients receiving cefazolin and gentamicin-containing regimens. The potential clinical relevance of these findings in the prevention of PJIs remains to be determined.
Databáze: OpenAIRE
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