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Clinical Features and Outcomes of Enterococcal Bone and Joint Infections and Factors Associated with Treatment Failure over a 13-Year Period in a French Teaching Hospital

Enterococcal bone and joint infections (BJIs) are reported to have poor outcomes, but there are conflicting results. This study aimed to describe the clinical characteristics and outcomes of patients with enterococcal BJI and to assess the factors associated with treatment failure. We conducted a re...

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Autores principales: Martin, Aurélie, Loubet, Paul, Salipante, Florian, Laffont-Lozes, Paul, Mazet, Julien, Lavigne, Jean-Philippe, Cellier, Nicolas, Sotto, Albert, Larcher, Romaric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220579/
https://www.ncbi.nlm.nih.gov/pubmed/37317187
http://dx.doi.org/10.3390/microorganisms11051213
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author Martin, Aurélie
Loubet, Paul
Salipante, Florian
Laffont-Lozes, Paul
Mazet, Julien
Lavigne, Jean-Philippe
Cellier, Nicolas
Sotto, Albert
Larcher, Romaric
author_facet Martin, Aurélie
Loubet, Paul
Salipante, Florian
Laffont-Lozes, Paul
Mazet, Julien
Lavigne, Jean-Philippe
Cellier, Nicolas
Sotto, Albert
Larcher, Romaric
author_sort Martin, Aurélie
collection PubMed
description Enterococcal bone and joint infections (BJIs) are reported to have poor outcomes, but there are conflicting results. This study aimed to describe the clinical characteristics and outcomes of patients with enterococcal BJI and to assess the factors associated with treatment failure. We conducted a retrospective cohort study at Nimes University Hospital from January 2007 to December 2020. The factors associated with treatment failure were assessed using a Cox model. We included 90 consecutive adult patients, 11 with native BJIs, 40 with prosthetic joint infections and 39 with orthopedic implant-associated infections. Two-thirds of patients had local signs of infection, but few (9%) had fever. Most BJIs were caused by Enterococcus faecalis (n = 82, 91%) and were polymicrobial (n = 75, 83%). The treatment failure rate was 39%, and treatment failure was associated with coinfection with Staphylococcus epidermidis (adjusted hazard ratio = 3.04, confidence interval at 95% [1.31–7.07], p = 0.01) and with the presence of local signs of inflammation at the time of diagnosis (aHR = 2.39, CI 95% [1.22–4.69], p = 0.01). Our results confirm the poor prognosis of enterococcal BJIs, prompting clinicians to carefully monitor for local signs of infection and to optimize the medical-surgical management in case of coinfections, especially with S. epidermidis.
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spelling pubmed-102205792023-05-28 Clinical Features and Outcomes of Enterococcal Bone and Joint Infections and Factors Associated with Treatment Failure over a 13-Year Period in a French Teaching Hospital Martin, Aurélie Loubet, Paul Salipante, Florian Laffont-Lozes, Paul Mazet, Julien Lavigne, Jean-Philippe Cellier, Nicolas Sotto, Albert Larcher, Romaric Microorganisms Article Enterococcal bone and joint infections (BJIs) are reported to have poor outcomes, but there are conflicting results. This study aimed to describe the clinical characteristics and outcomes of patients with enterococcal BJI and to assess the factors associated with treatment failure. We conducted a retrospective cohort study at Nimes University Hospital from January 2007 to December 2020. The factors associated with treatment failure were assessed using a Cox model. We included 90 consecutive adult patients, 11 with native BJIs, 40 with prosthetic joint infections and 39 with orthopedic implant-associated infections. Two-thirds of patients had local signs of infection, but few (9%) had fever. Most BJIs were caused by Enterococcus faecalis (n = 82, 91%) and were polymicrobial (n = 75, 83%). The treatment failure rate was 39%, and treatment failure was associated with coinfection with Staphylococcus epidermidis (adjusted hazard ratio = 3.04, confidence interval at 95% [1.31–7.07], p = 0.01) and with the presence of local signs of inflammation at the time of diagnosis (aHR = 2.39, CI 95% [1.22–4.69], p = 0.01). Our results confirm the poor prognosis of enterococcal BJIs, prompting clinicians to carefully monitor for local signs of infection and to optimize the medical-surgical management in case of coinfections, especially with S. epidermidis. MDPI 2023-05-05 /pmc/articles/PMC10220579/ /pubmed/37317187 http://dx.doi.org/10.3390/microorganisms11051213 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Martin, Aurélie
Loubet, Paul
Salipante, Florian
Laffont-Lozes, Paul
Mazet, Julien
Lavigne, Jean-Philippe
Cellier, Nicolas
Sotto, Albert
Larcher, Romaric
Clinical Features and Outcomes of Enterococcal Bone and Joint Infections and Factors Associated with Treatment Failure over a 13-Year Period in a French Teaching Hospital
title Clinical Features and Outcomes of Enterococcal Bone and Joint Infections and Factors Associated with Treatment Failure over a 13-Year Period in a French Teaching Hospital
title_full Clinical Features and Outcomes of Enterococcal Bone and Joint Infections and Factors Associated with Treatment Failure over a 13-Year Period in a French Teaching Hospital
title_fullStr Clinical Features and Outcomes of Enterococcal Bone and Joint Infections and Factors Associated with Treatment Failure over a 13-Year Period in a French Teaching Hospital
title_full_unstemmed Clinical Features and Outcomes of Enterococcal Bone and Joint Infections and Factors Associated with Treatment Failure over a 13-Year Period in a French Teaching Hospital
title_short Clinical Features and Outcomes of Enterococcal Bone and Joint Infections and Factors Associated with Treatment Failure over a 13-Year Period in a French Teaching Hospital
title_sort clinical features and outcomes of enterococcal bone and joint infections and factors associated with treatment failure over a 13-year period in a french teaching hospital
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220579/
https://www.ncbi.nlm.nih.gov/pubmed/37317187
http://dx.doi.org/10.3390/microorganisms11051213
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