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2015 ; 4
(3
): 307-19
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gab.com Text
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English Wikipedia
High Frequency of Polymicrobial Infections After Surgical Resection of Malignant
Bone and Soft Tissue Tumors: A Retrospective Cohort Study
#MMPMID26334238
Vos LM
; Morand PC
; Biau D
; Archambeau D
; Eyrolle LJ
; Loubinoux J
; Perut V
; Leclerc P
; Arends JE
; Anract P
; Salmon D
Infect Dis Ther
2015[Sep]; 4
(3
): 307-19
PMID26334238
show ga
INTRODUCTION: Surgical resection of a malignant bone tumor (BT) or soft tissue
tumor (STT), with or without prosthetic replacement, carries a high risk of
developing postoperative infections. There is limited knowledge on the
bacteriological spectrum of these postsurgical infections that necessitate
empirical antibiotic therapy. The aim of this study was to analyze the incidence
and microbiological features of site infections following BT or STT resection.
METHODS: In this retrospective mono-center study, we analyzed the surgical and
bacteriological data of all consecutive patients who developed an infection after
surgical resection of a BT or STT between January 2010 and April 2014. RESULTS:
Seventy-two consecutive patients who developed an infection on the site of
surgical treatment for a BT (n = 42) or SST (n = 30) were included. Polymicrobism
was frequently observed, more often associated with STTs (93%) than BTs (71%;
P = 0.03). Gram-negative bacteria were more frequently isolated in STTs (55%)
than in BTs (26%; P = 0.01) and non-prosthesis-associated infections (54%) than
prosthesis-associated infections (29%; P = 0.04), whereas staphylococci were more
frequently found in BTs (76%) than in STTs (52%; P = 0.03). Overall, we found
gram negatives in 82% of early acute infections, 11% of chronic infections and 7%
of late acute infections (P < 0.01). CONCLUSION: Postoperative infections in
patients after surgical resection of BTs or STTs were often polymicrobial,
especially following STTs. Causative bacteria were often gram negatives in STTs
and non-prosthesis-associated infections, whereas staphylococci were predominant
in BTs. Based on these findings, we recommend antibiotic coverage of both
gram-positive and -negative bacteria with a combination of broad-spectrum
antibiotics in STTs and antistaphylococcal antibiotics as first-line therapy in
infections following BT surgery.