title: Characteristics and prognosis in patients with prosthetic vascular graft infection: a prospective observational cohort study.
abstract: Prosthetic vascular graft infection (PVGI) is a devastating complication, with a mortality rate of up to 75%, which is especially caused by aortic graft infection. The purpose of this study was to evaluate factors associated with in-hospital mortality of patients with definite graft infection, and with long-term outcome. We reviewed medical records of 85 patients treated for PVGIs defined by positive bacterial culture of intraoperative specimens or blood samples, and/or clinical, biological and radiological signs of infection. In-hospital patient mortality was defined as any death occurring during the initial treatment of the graft infection. Cure was defined as the absence of evidence of relapsing infection during long-term follow-up (≥1 year). Eighty-five patients (54 aortic and 31 limb graft infections) treated by surgical debridement and removal of the infected prosthesis (n=41), surgical debridement without removal of prosthesis (n=34) or antimicrobial treatment without surgery (n=10) were studied. The only microbiological difference observed between patients with early (occurring within 4 months after surgery) vs. late PVGI and between those with aortic vs. limb PVGI was the incidence of PVGI caused by Staphylococcus aureus, which was greater in patients with limb PVGI. Overall cure was observed in 93.2% of 59 patients with a follow-up of a minimum of 1 year. Overall in-hospital mortality was 16.5% (n=14). Two variables were independently associated with mortality: age >70 years (OR 9.1, 95% CI 1.83-45.43, p 0.007) and aortic graft infection (OR 5.6, 95% CI 1.1-28.7, p 0.037).
authors: Infectious Diseases Department, Rue du Président Coty, 59208 Tourcoing, France. laurence.legout@free.fr
authors: L
authors: L
authors: Legout
authors: B
authors: B
authors: Sarraz-Bournet
authors: P V
authors: PV
authors: D'Elia
authors: P
authors: P
authors: Devos
authors: A
authors: A
authors: Pasquet
authors: M
authors: M
authors: Caillaux
authors: F
authors: F
authors: Wallet
authors: Y
authors: Y
authors: Yazdanpanah
authors: E
authors: E
authors: Senneville
authors: S
authors: S
authors: Haulon
authors: O
authors: O
authors: Leroy
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000472:pathogenicity*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification / Q000472:pathogenicity; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality* / Q000473:pathology; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents