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International Orthopaedics

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Open Access 01-03-2022 | Candida Balanitis | Original Paper

Candida periprosthetic joint infections — risk factors and outcome between albicans and non-albicans strains

Authors: Daniel Karczewski, Yi Ren, Octavian Andronic, Doruk Akgün, Carsten Perka, Michael Müller, Arne Kienzle

Published in: International Orthopaedics | Issue 3/2022

Abstract

Background

Despite its scarcity, fungal periprosthetic joint infection (PJI) is of great clinical relevance as diagnosis and treatment are highly challenging. Previous analyses focused on the treatment rather than the role of the causative fungal agent on clinical outcome. This is the largest study of its kind to evaluate Candida strain–dependent differences in patients with fungal PJI.

Methods

We retrospectively analyzed 29 patients who underwent surgical intervention due to Candida hip or knee PJI in our department from 2010 to 2018. PJI was defined according to IDSA, recurrent PJI according to modified Delphi consensus criteria. Statistical analysis was performed using t-test, chi-square test with Yates correction, and log rank test.

Results

Besides age and affected joint, no significant differences were found between Candida albicans and non-albicans PJI patients (75.83 versus 64.11 years, p = 0.012; 12 hip versus two knee cases, p = 0.013). Most patients received two- (27.59%) or three-stage exchange surgery (41.38%). There was a statistical trend towards an increase in surgery needed in non-albicans Candida PJI (2.92 versus 2.12; p = 0.103). After initial Candida PJI treatment, functional prosthesis implantation was achieved in 72.41% of all patients. At last follow-up, infection-free survival was at 26.79% in Candida albicans versus 72.00% in non-albicans PJI (p = 0.046).

Conclusions

In this study, we found infection-free survival rates to be significantly decreased in patients with albicans compared to non-albicans Candida PJI. While age and affected joint might play a confounding role, we speculate the causative pathogen to play a decisive role in disease progression.

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Title: Candida periprosthetic joint infections — risk factors and outcome between albicans and non-albicans strains
Authors: Daniel Karczewski
Yi Ren
Octavian Andronic
Doruk Akgün
Carsten Perka
Michael Müller
Arne Kienzle
Publication date: 01-03-2022
Publisher: Springer Berlin Heidelberg
Keywords: Candida Balanitis
Candida Albicans
Joint Infection
Hip-TEP
Hip-TEP
Published in: International Orthopaedics / Issue 3/2022
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-021-05214-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Candida periprosthetic joint infections — risk factors and outcome between albicans and non-albicans strains

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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