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Factors predictive of treatment failure in staphylococcal prosthetic vascular graft infections: a prospective observational cohort study: impact of rifampin
- Source :
- BMC Infectious Diseases
- Publication Year :
- 2013
-
Abstract
- Background There exists considerable debate concerning management of prosthetic vascular graft infection (PVGI), especially in terms of antimicrobial treatment. This report studies factors associated with treatment failure in a cohort of patients with staphylococcal PVGI, along with the impact of rifampin (RIF). Methods All data on patients with PVGI between 2006 and 2010 were reviewed. Cure was defined as the absence of evidence of infection during the entire post-treatment follow-up for a minimum of one year. Failure was defined as any other outcome. Results 84 patients (72 M/12 F, median age 64.5 ± 11 y) with diabetes mellitus (n = 25), obesity (n = 48), coronary artery disease (n = 48), renal failure (n = 24) or COPD (n = 22) were treated for PVGI (median follow-up was 470 ± 469 d). PVGI was primarily intracavitary (n = 47). Staphylococcus aureus (n = 65; including 17 methicillin-resistant S. aureus) and coagulase-negative Staphylocococcus (n = 22) were identified. Surgical treatment was performed in 71 patients. In univariate analysis, significant risk factors associated with failure were renal failure (p = 0.04), aortic aneurysm (p = 0.03), fever (p = 0.009), aneurysm disruption (p = 0.02), septic shock in the peri-operative period (p = 0.005) and antibiotic treatment containing RIF (p = 0.03). In multivariate analysis, 2 variables were independently associated with failure:septic shock [OR 4.98: CI 95% 1.45-16.99; p=0.01] and antibiotic containing rifampin [OR: 0.32: CI95% 0.10-0.96; p=0.04]. Conclusion Results of the present study suggest that fever, septic shock and non-use of antibiotic treatment containing RIF are associated with poor outcome.
- Subjects :
- Male
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
Staphylococcus aureus
Prosthesis infection
Prosthesis-Related Infections
Vascular graft infection
Treatment failure
Cohort Studies
Blood Vessel Prosthesis Implantation
Medical microbiology
Risk Factors
Internal medicine
polycyclic compounds
medicine
Humans
Prospective Studies
Treatment Failure
Aged
Staphylococci
business.industry
biochemical phenomena, metabolism, and nutrition
Middle Aged
Staphylococcal Infections
Antimicrobial
Shock, Septic
Surgery
Anti-Bacterial Agents
Infectious Diseases
Tropical medicine
Cohort
Multivariate Analysis
Female
France
Rifampin
business
Vascular graft
Cohort study
Research Article
Subjects
Details
- ISSN :
- 14712334
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- BMC infectious diseases
- Accession number :
- edsair.doi.dedup.....c1b0773ef54924b3fdca10cf27fd6e9c