Therapeutic Strategies for Post-Osteosynthesis Osteomyelitis
Journal Title: Journal of Infectious Diseases & Therapy - Year 2017, Vol 5, Issue 1
Abstract
Objectives: The main objective in post-osteosynthesis surgical site infection (SSI) is to consolidate the fracture and prevent chronic osteomyelitis. The purpose of this study is to evaluate the risk factors for SSI recurrence in patients treated for osteo-articular infection at the Federal University of São Paulo. Methods: After retrospectively evaluating all SSI episodes occurring from December 2004 to December 2008 in patients undergoing osteosynthesis at the orthopedics department, 110 of them were included. SSIs were treated with at least 4-6 week antibiotic therapy cycles and followed up for one year with the results being analyzed using univariate and multivariate analysis models. Results: Most patients were 18-89 years old, with a mean age of 39.8, the majority being male (84.5%). In 37 patients, the causative agent was isolated with Staphylococcus being the most frequently observed (38.8%). In 83 (75.4%) patients, the antimicrobial treatment mostly with ciprofloxacin and clindamycin was started within less than five days from the onset of symptoms. SSI recurrence occurred in 34/110 (30.9%) patients. After one-year follow-up, 19 (17.3%) patients persisted with infection and only 10 (9.1%) did not have their fractures consolidated. The univariate analysis showed the performance of more than one surgery to stabilize the affected limb (OR 3.7 IC95=1.1-12.7 p=0.045), presence of converting osteosynthesis (OR 3.6 IC95=1.1-11.3 p=0.023), internal synthesis (OR 3.0 IC95=0.99-9.2 p=0.043) and longer duration of surgery (OR 0.4 IC95=0.1-1.6 p=0.029) as risk factors for SSI recurrence. In the multivariate analysis, the only variable independently associated with SSI relapse was duration of surgery (OR 1.3 IC95=1.1-1.7 p=0.015). Conclusions: After one year follow-up, using a specific protocol, most patients showed resolution of infection and only 9.1% had their fractures unconsolidated. The only independent risk factor associated with SSI recurrence was prolonged surgery. It is possible to treat a patient with post-osteosynthesis SSI with a course of 4 to 6 weeks of antibiotic therapy.
Authors and Affiliations
Dell'Aquila AM
Keywords
Related Articles
- EP ID EP363518
- DOI 10.4172/2332-0877.1000312
- Views 46
- Downloads 0
Therapeutic Strategies for Post-Osteosynthesis Osteomyelitis
Objectives: The main objective in post-osteosynthesis surgical site infection (SSI) is to consolidate the fracture and prevent chronic osteomyelitis. The purpose of this study is to evaluate the risk factors for SSI recu...
The Role of Neutrophil Extracellular Traps in Infectious Diseases
Neutrophils were recently thought as a key player of the innate immune response, and one of the defense mechanisms of these cells: Neutrophil extracellular traps (NETs) whereby they capture pathogens by actively releasin...
Exposure of Health Care Workers to Crimean-Congo Hemorrhagic Fever in Senegal: An Investigation of Two Imported Cases
Introduction: Crimean Congo hemorrhagic fever (CCHF) is a potentially fatal arbovirus with a high risk for nosocomial transmission. The goals of this study were to describe two cases of imported CCHF in Senegal and to ev...
Prevalence of Pandemic Influenza a (H1N1) Virus and Cytomegalovirus Co- Existence at an Early Stage in Evangelismos Hospital-ICU Patients
Objective: Cytomegalovirus (CMV) infections in immunocompetent ICU patients have been associated with poor outcomes. We determined the distribution of cytomegalovirus coinfection among patients admitted in the ICU1 of Ev...
Complete Remission of Primary Cutaneous Cryptococcosis in an Immunosuppressed Patient after Fluconazole Treatment
Cryptococcus neoformans is opportunistic encapsulated yeast that represents the most frequent cryptococcal species found in humans. It can cause three types of infections: pulmonary cryptococcosis, cryptococcal meningiti...