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Successful treatment for acute prosthetic joint infection due to MRSA and Candida albicans: a case report and literature review

Methicillin-resistant Staphylococcus aureus (MRSA) and Candidal prosthetic joint infections (PJIs) are very rare, and the optimal management for these patients is still unknown. A 54-year-old man with traumatic arthritis due to previous electric injury successfully retained the implant despite the s...

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Autores principales: Xiang, Yong, Xuan, Yi-Yi, Li, Guangheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016578/
https://www.ncbi.nlm.nih.gov/pubmed/29950850
http://dx.doi.org/10.2147/TCRM.S165247
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author Xiang, Yong
Xuan, Yi-Yi
Li, Guangheng
author_facet Xiang, Yong
Xuan, Yi-Yi
Li, Guangheng
author_sort Xiang, Yong
collection PubMed
description Methicillin-resistant Staphylococcus aureus (MRSA) and Candidal prosthetic joint infections (PJIs) are very rare, and the optimal management for these patients is still unknown. A 54-year-old man with traumatic arthritis due to previous electric injury successfully retained the implant despite the successive infection with MRSA and Candida albicans after total knee arthroplasty (TKA). Continuous lavage with vancomycin was used to control MRSA infection and repeated local washout plus oral swallow with voriconazole tablet were administered to eradicate C. albicans. Additional three reported cases were identified by the criteria of selecting patients with concomitant and/or successive MRSA and Candidal PJIs. Different methods were applied with variable outcomes. Therefore, several risk factors such as intra-articular corticosteroid injection, high frequency of door openings in the operating room, excessive blood loss and allogeneic red blood cell transfusions should be avoided. Debridement, antibiotics and implant retention (DAIR) can be an alternative in dedicated patients to control acute MRSA and Candidal PJIs. Particularly, repeated intra-articular washout with susceptible drugs and a prolonged duration of oral antibiotics was essential for microbial control.
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spelling pubmed-60165782018-06-27 Successful treatment for acute prosthetic joint infection due to MRSA and Candida albicans: a case report and literature review Xiang, Yong Xuan, Yi-Yi Li, Guangheng Ther Clin Risk Manag Original Research Methicillin-resistant Staphylococcus aureus (MRSA) and Candidal prosthetic joint infections (PJIs) are very rare, and the optimal management for these patients is still unknown. A 54-year-old man with traumatic arthritis due to previous electric injury successfully retained the implant despite the successive infection with MRSA and Candida albicans after total knee arthroplasty (TKA). Continuous lavage with vancomycin was used to control MRSA infection and repeated local washout plus oral swallow with voriconazole tablet were administered to eradicate C. albicans. Additional three reported cases were identified by the criteria of selecting patients with concomitant and/or successive MRSA and Candidal PJIs. Different methods were applied with variable outcomes. Therefore, several risk factors such as intra-articular corticosteroid injection, high frequency of door openings in the operating room, excessive blood loss and allogeneic red blood cell transfusions should be avoided. Debridement, antibiotics and implant retention (DAIR) can be an alternative in dedicated patients to control acute MRSA and Candidal PJIs. Particularly, repeated intra-articular washout with susceptible drugs and a prolonged duration of oral antibiotics was essential for microbial control. Dove Medical Press 2018-06-20 /pmc/articles/PMC6016578/ /pubmed/29950850 http://dx.doi.org/10.2147/TCRM.S165247 Text en © 2018 Xiang et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Xiang, Yong
Xuan, Yi-Yi
Li, Guangheng
Successful treatment for acute prosthetic joint infection due to MRSA and Candida albicans: a case report and literature review
title Successful treatment for acute prosthetic joint infection due to MRSA and Candida albicans: a case report and literature review
title_full Successful treatment for acute prosthetic joint infection due to MRSA and Candida albicans: a case report and literature review
title_fullStr Successful treatment for acute prosthetic joint infection due to MRSA and Candida albicans: a case report and literature review
title_full_unstemmed Successful treatment for acute prosthetic joint infection due to MRSA and Candida albicans: a case report and literature review
title_short Successful treatment for acute prosthetic joint infection due to MRSA and Candida albicans: a case report and literature review
title_sort successful treatment for acute prosthetic joint infection due to mrsa and candida albicans: a case report and literature review
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016578/
https://www.ncbi.nlm.nih.gov/pubmed/29950850
http://dx.doi.org/10.2147/TCRM.S165247
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