与假体关节感染有关的特定微生物学问题

Umraz Khan, G. Perks, R. Morgan-Jones, P. James, Colin Esler, V. Smyth, V. Gant
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摘要

本章讨论了与假体关节感染(PJI)相关的特定微生物学问题,包括抗生素预防(包括未感染病例的选择性关节置换术)、感染或推定感染病例的“预防/治疗”选择、安全操作的建议框架、耐药性时代PJI中的抗生素使用、抗生素耐药性上升的背景、一期和二期手术管理的方法。门诊抗生素治疗和何时使用,监测/停止规则,PJI中假单胞菌和念珠菌的特殊问题,以及关于“免疫抑制”在实践中的实际含义(包括MRSA)的神话和事实,以及结论。
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Specific microbiology issues relating to prosthetic joint infection
This chapter discusses specific microbiology issues relating to prosthetic joint infection (PJI) and includes discussion on antibiotic prophylaxis (including elective joint replacement in the uninfected case), choice of ‘prophylaxis/treatment’ in the infected, or presumed, infected case, a suggested framework for a safe practice, antibiotic use in PJI in the age of resistance, background on rising antibiotic resistance, approach to one- and two-stage surgical management, outpatient antibiotic therapy and when to use it, monitoring/stopping rules, the particular problems of Pseudomonas and Candida in PJI, and myths and facts about what ‘immunosuppression’ actually means in practice (including MRSA), and a conclusion.
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Pathways for established prosthetic joint infection Revision arthroplasty networks Thromboprophylaxis and haematomas Preoperative assessment Specific microbiology issues relating to prosthetic joint infection
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