@article{10902/34591,
year = {2024},
url = {https://hdl.handle.net/10902/34591},
abstract = {Background: Prosthetic joint infection (PJI) caused by Candida spp is a severe complication of arthroplasty. We investigated the outcomes of Candida PJI. Methods: This was a retrospective observational multinational study including patients diagnosed with Candida-related PJI between 2010 and 2021. Treatment outcome was assessed at 2-year follow-up. Results: A total of 269 patients were analyzed. Median age was 73.0 (interquartile range [IQR], 64.0-79.0) years; 46.5% of patients were male and 10.8% were immunosuppressed. Main infection sites were hip (53.0%) and knee (43.1%), and 33.8% patients had fistulas. Surgical procedures included debridement, antibiotics, and implant retention (DAIR) (35.7%), 1-stage exchange (28.3%), and 2-stage exchange (29.0%). Candida spp identified were Candida albicans (55.8%), Candida parapsilosis (29.4%), Candida glabrata (7.8%), and Candida tropicalis (5.6%). Coinfection with bacteria was found in 51.3% of cases. The primary antifungal agents prescribed were azoles (75.8%) and echinocandins (30.9%), administered for a median of 92.0 (IQR, 54.5-181.3) days. Cure was observed in 156 of 269 (58.0%) cases. Treatment failure was associated with age >70 years (OR, 1.811 [95% confidence interval {CI}: 1.079-3.072]), and the use of DAIR (OR, 1.946 [95% CI: 1.157-3.285]). Candida parapsilosis infection was associated with better outcome (OR, 0.546 [95% CI: .305-.958]). Cure rates were significantly different between DAIR versus 1-stage exchange (46.9% vs 67.1%, P = .008) and DAIR versus 2-stage exchange (46.9% vs 69.2%, P = .003), but there was no difference comparing 1- to 2-stage exchanges (P = .777). Conclusions: Candida PJI prognosis seems poor, with high rate of failure, which does not appear to be linked to immunosuppression, use of azoles, or treatment duration.},
publisher = {Oxford University Press},
publisher = {Clinical Infectious Diseases, 2024, ciae395, 1-9},
title = {Prosthetic joint infections due to Candida species: a multicenter international study},
author = {Dinh, Aurélien and MacNally, Martin and D'Anglejan, Emma and Kilu, Christel Mamona and Lourtet, Julie and Ho, Rosemary and Scarborough, Matthew and Dudareva, Maria and Jesuthasan, Gerald and Oustau, Cecile Ronde and Klein, Stéphane and Escolà-Vergé, Laura and Rodríguez Pardo, Dolores and Delobel, Pierre and Lora-Tamayo, Jaime and Mancheño-Losa, Mikel and Sorlí Redó, María Luisa and Barbero Allende, José María and Fernández Sampedro, Marta},
}