Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods?
<p class="p p-first" id="__p2"><strong><em>Background</em></strong>: 1<sup>st</sup> and 2<sup>nd</sup> generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negati...
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| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2017-01-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/2/73/2017/jbji-2-73-2017.pdf |
| _version_ | 1818736323024912384 |
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| author | O. Jamei S. Gjoni B. Zenelaj B. Kressmann B. Kressmann W. Belaieff D. Hannouche I. Uçkay I. Uçkay |
| author_facet | O. Jamei S. Gjoni B. Zenelaj B. Kressmann B. Kressmann W. Belaieff D. Hannouche I. Uçkay I. Uçkay |
| author_sort | O. Jamei |
| collection | DOAJ |
| description | <p class="p p-first" id="__p2"><strong><em>Background</em></strong>: 1<sup>st</sup> and 2<sup>nd</sup> generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negative rods (NFR).</p><p id="__p3"><strong><em>Methods: </em></strong>Epidemiological cohort study of adult patients operated for orthopedic infections between 2004 and 2014 with perioperative cefuroxim or vancomycin prophylaxis. Exclusion of polyneuropathic ischemic foot infections and septic bursitis cases.</p><p id="__p4"><strong><em>Results:</em></strong> Of the total 1840 surgical procedures in the study, 430 grew Gram-negative pathogens (23%), of which 194 (11%) were due to NFR and 143 (8%) to <em>Pseudomonas aeruginosa</em>. Overall, 634 episodes (35%) involved orthopaedic implants (321 arthroplasties, 135 plates, 53 nails, and others). In multivariate analysis and group comparisons, especially preoperative antibiotic use (124/194 vs. 531/1456; <em>p</em><0.01) was significantly associated with NFR.</p><p class="p p-last" id="__p5"><strong><em>Conclusions: </em></strong>Overall proportion of NFR oscillated between 9% and 13% among our orthopaedic infections. Variables associated with NFR were antibiotic use prior to hospitalization. The low infection rate of NFR following elective surgery and the community-based epidemiology, has led us to keep our standard perioperative prophylaxis unchanged.</p> |
| first_indexed | 2024-12-18T00:35:19Z |
| format | Article |
| id | doaj.art-38a3a0e9bd7045ac9d20c9f1f3b7f819 |
| institution | Directory Open Access Journal |
| issn | 2206-3552 |
| language | English |
| last_indexed | 2024-12-18T00:35:19Z |
| publishDate | 2017-01-01 |
| publisher | Copernicus Publications |
| record_format | Article |
| series | Journal of Bone and Joint Infection |
| spelling | doaj.art-38a3a0e9bd7045ac9d20c9f1f3b7f8192022-12-21T21:27:03ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522017-01-012737610.7150/jbji.17171Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods?O. Jamei0S. Gjoni1B. Zenelaj2B. Kressmann3B. Kressmann4W. Belaieff5D. Hannouche6I. Uçkay7I. Uçkay8Orthopaedic Surgery ServiceDivision of General Medical RehabilitationOrthopaedic Surgery ServiceOrthopaedic Surgery ServiceService of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, SwitzerlandOrthopaedic Surgery ServiceOrthopaedic Surgery ServiceOrthopaedic Surgery ServiceService of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Switzerland<p class="p p-first" id="__p2"><strong><em>Background</em></strong>: 1<sup>st</sup> and 2<sup>nd</sup> generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negative rods (NFR).</p><p id="__p3"><strong><em>Methods: </em></strong>Epidemiological cohort study of adult patients operated for orthopedic infections between 2004 and 2014 with perioperative cefuroxim or vancomycin prophylaxis. Exclusion of polyneuropathic ischemic foot infections and septic bursitis cases.</p><p id="__p4"><strong><em>Results:</em></strong> Of the total 1840 surgical procedures in the study, 430 grew Gram-negative pathogens (23%), of which 194 (11%) were due to NFR and 143 (8%) to <em>Pseudomonas aeruginosa</em>. Overall, 634 episodes (35%) involved orthopaedic implants (321 arthroplasties, 135 plates, 53 nails, and others). In multivariate analysis and group comparisons, especially preoperative antibiotic use (124/194 vs. 531/1456; <em>p</em><0.01) was significantly associated with NFR.</p><p class="p p-last" id="__p5"><strong><em>Conclusions: </em></strong>Overall proportion of NFR oscillated between 9% and 13% among our orthopaedic infections. Variables associated with NFR were antibiotic use prior to hospitalization. The low infection rate of NFR following elective surgery and the community-based epidemiology, has led us to keep our standard perioperative prophylaxis unchanged.</p>https://jbji.copernicus.org/articles/2/73/2017/jbji-2-73-2017.pdf |
| spellingShingle | O. Jamei S. Gjoni B. Zenelaj B. Kressmann B. Kressmann W. Belaieff D. Hannouche I. Uçkay I. Uçkay Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods? Journal of Bone and Joint Infection |
| title | Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods? |
| title_full | Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods? |
| title_fullStr | Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods? |
| title_full_unstemmed | Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods? |
| title_short | Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods? |
| title_sort | which orthopaedic patients are infected with gram negative non fermenting rods |
| url | https://jbji.copernicus.org/articles/2/73/2017/jbji-2-73-2017.pdf |
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