Diagnosis of Periprosthetic Infection by Using ESR and CRP ：用ESR和CRP诊断假体周围感染.pptVIP

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2018-06-06 发布于浙江
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Diagnosis of Periprosthetic Infection by Using ESR and CRP ：用ESR和CRP诊断假体周围感染.ppt

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Diagnosis of Periprosthetic Infection by Using ESR and CRP ：用ESR和CRP诊断假体周围感染

The cohort received a variety of surgical treatment with most of them being treated by two-stage exchange arthroplasty. There were some patients who underwent one-stage exchange and others that received ID of the infected joint * Staphylococcus aureus and Staphylococcus epidermidis (methicillin sensitive and resistant) comprised the vast majority of the gram positive pathogens (80%), and of the total number of pathogens (71%) * * * 156 had culture positive on gram stain 57% * 156 had culture positive on gram stain 57% * * * * * No significant statistical difference. Follow up is available on 113+68 (181) in one group and 25+7(32) in the other group. * * The change in the organism profile for PJI, at least as observed in two institutions, is concerning. There appears to be a rise in the incidence of PJI caused by resistant organisms. If confirmed in other institutions, this trend could present a real challenge as treatment of PJI caused by resistant organisms appears to be suboptimal. * There appears to be a dire need for design of diagnostic methods that will enable clinicians to isolate infecting organisms and deliver appropriate antibacterial treatment. * * Benjamin Bender MD Ashok Gowda BS Khalid Azzam MD Elie Ghanem MD James Purtill MD Javad Parvizi MD, FRCS Rothman Institute Thomas Jefferson University Hospital Philadelphia, PA Periprosthetic joint infection (PJI) 1.5%–2.5% after primary hip or knee arthroplasty Marked morbidity and mortality Challenging Periprosthetic joint infection (PJI) Effective delivery of antibiotics Based on the type and antibiotic sensitivity of the infecting organism This study reports The high false negative rate of microbiological studies And Compares the outcome of treatment for PJI when the organism was identified versus culture negative cases. Methods/Materials Patients with PJI between 1999 to 2006 Electronic microbiological database (1999) Detailed review of medical records Methods/Materials 384 patients