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Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections
BACKGROUND: Optimal timing for rifampicin combination therapy in patients with staphylococcal vascular graft/endograft infection (S-VGEI) is unknown. Experts recommend adding rifampicin after lowering bacterial load by surgery and wound closure. OBJECTIVES: To assess predictors of rifampicin resista...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209986/ https://www.ncbi.nlm.nih.gov/pubmed/34223108 http://dx.doi.org/10.1093/jacamr/dlab041 |
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author | Leung, Yau Kei Stefan Ledergerber, Bruno Eberhard, Nadia Mestres, Carlos A Rancic, Zoran Zimmermann, Alexander Zbinden, Reinhard Brugger, Silvio D Zinkernagel, Annelies S Hasse, Barbara |
author_facet | Leung, Yau Kei Stefan Ledergerber, Bruno Eberhard, Nadia Mestres, Carlos A Rancic, Zoran Zimmermann, Alexander Zbinden, Reinhard Brugger, Silvio D Zinkernagel, Annelies S Hasse, Barbara |
author_sort | Leung, Yau Kei Stefan |
collection | PubMed |
description | BACKGROUND: Optimal timing for rifampicin combination therapy in patients with staphylococcal vascular graft/endograft infection (S-VGEI) is unknown. Experts recommend adding rifampicin after lowering bacterial load by surgery and wound closure. OBJECTIVES: To assess predictors of rifampicin resistance among staphylococci isolated from patients in the Vascular Graft Infection Cohort Study. METHODS: We included prospective patients with S-VGEI diagnosis from 1 January 2002 to 30 June 2020. We retrospectively assessed determinants of rifampicin resistance using exact logistic regression and described survival with Kaplan–Meier curves. RESULTS: We analysed 513 Staphylococcus spp. among 143 predominantly male (82%) patients with a median age of 68 years (IQR 60–75). Thereof, 82 (57%) received a rifampicin combination therapy and 61 (43%) received an antimicrobial therapy without rifampicin. Among 82 patients with rifampicin, 26/26 patients with any rifampicin resistance had open wounds with a strong association of rifampicin resistance with rifampicin treatment while having open wounds (OR 37, 95% CI 6.1 to ∞). Among 75 patients with a rifampicin combination therapy and rifampicin-susceptible staphylococci at S-VGEI diagnosis, 12/12 patients with a secondary rifampicin-resistant isolate had an open wound (OR 14, 95% CI 2.1 to ∞). CONCLUSIONS: Rifampicin should be started after wound closure due to increased risk of rifampicin resistance observed while having open wounds or second-look surgeries among patients with S-VGEI. |
format | Online Article Text |
id | pubmed-8209986 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-82099862021-07-02 Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections Leung, Yau Kei Stefan Ledergerber, Bruno Eberhard, Nadia Mestres, Carlos A Rancic, Zoran Zimmermann, Alexander Zbinden, Reinhard Brugger, Silvio D Zinkernagel, Annelies S Hasse, Barbara JAC Antimicrob Resist Original Article BACKGROUND: Optimal timing for rifampicin combination therapy in patients with staphylococcal vascular graft/endograft infection (S-VGEI) is unknown. Experts recommend adding rifampicin after lowering bacterial load by surgery and wound closure. OBJECTIVES: To assess predictors of rifampicin resistance among staphylococci isolated from patients in the Vascular Graft Infection Cohort Study. METHODS: We included prospective patients with S-VGEI diagnosis from 1 January 2002 to 30 June 2020. We retrospectively assessed determinants of rifampicin resistance using exact logistic regression and described survival with Kaplan–Meier curves. RESULTS: We analysed 513 Staphylococcus spp. among 143 predominantly male (82%) patients with a median age of 68 years (IQR 60–75). Thereof, 82 (57%) received a rifampicin combination therapy and 61 (43%) received an antimicrobial therapy without rifampicin. Among 82 patients with rifampicin, 26/26 patients with any rifampicin resistance had open wounds with a strong association of rifampicin resistance with rifampicin treatment while having open wounds (OR 37, 95% CI 6.1 to ∞). Among 75 patients with a rifampicin combination therapy and rifampicin-susceptible staphylococci at S-VGEI diagnosis, 12/12 patients with a secondary rifampicin-resistant isolate had an open wound (OR 14, 95% CI 2.1 to ∞). CONCLUSIONS: Rifampicin should be started after wound closure due to increased risk of rifampicin resistance observed while having open wounds or second-look surgeries among patients with S-VGEI. Oxford University Press 2021-03-25 /pmc/articles/PMC8209986/ /pubmed/34223108 http://dx.doi.org/10.1093/jacamr/dlab041 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Leung, Yau Kei Stefan Ledergerber, Bruno Eberhard, Nadia Mestres, Carlos A Rancic, Zoran Zimmermann, Alexander Zbinden, Reinhard Brugger, Silvio D Zinkernagel, Annelies S Hasse, Barbara Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections |
title | Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections |
title_full | Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections |
title_fullStr | Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections |
title_full_unstemmed | Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections |
title_short | Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections |
title_sort | open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209986/ https://www.ncbi.nlm.nih.gov/pubmed/34223108 http://dx.doi.org/10.1093/jacamr/dlab041 |
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