title: Diagnosis and management of prosthetic vascular graft infections.
abstract: Prosthetic vascular graft infection is a rare but very severe complication with a high death rate. Its optimal management requires appropriate surgical procedures combined with adequate antimicrobial treatment in reference center. The authors wanted to focus on the management of prosthetic vascular graft infection and define the clinical, microbiological, biological, and radiological criteria of vascular graft infection. Complementary investigations, although these are small series, include CT scan, the gold standard for the diagnosis of acute infection with a sensitivity and specificity reaching 100%, but decreased to 55% in case of chronic infection. More recently, PET-scanning was studied and yielded good results in chronic infections (sensitivity 98%, specificity 75.6%, positive predictive value 88.5%, and negative predictive value 84.4%). Managing prosthetic vascular graft infection, as with the orthopedic and vascular infections, requires replacing the vascular prosthesis. There is no correlation between the microbiological data and the location or type of vascular infection. Thus, the postoperative intravenous antibiotherapy should be bactericidal with a broad-spectrum. After obtaining intra-operative microbiological results, de-escalation therapy must include at least one anti-adherence agent, such as rifampicin in staphylococcal infections.
authors.affiliation: Service Universitaire de Maladies Infectieuses, Centre Hospitalier Dron, Rue du Président-Coty, 59208 Tourcoing, France. laurence.legout@free.fr
authors.forename: L
authors.initials: L
authors.lastname: Legout
authors.forename: P V
authors.initials: PV
authors.lastname: D'Elia
authors.forename: B
authors.initials: B
authors.lastname: Sarraz-Bournet
authors.forename: S
authors.initials: S
authors.lastname: Haulon
authors.forename: A
authors.initials: A
authors.lastname: Meybeck
authors.forename: E
authors.initials: E
authors.lastname: Senneville
authors.forename: O
authors.initials: O
authors.lastname: Leroy
mesh_terms: D000359:Aftercare; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001422:Bacterial Adhesion / Q000187:drug effects; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003287:Contrast Media; D020878:Device Removal; D003952:Diagnostic Imaging / Q000379:methods*; D019468:Disease Management; D004352:Drug Resistance, Microbial; D006801:Humans; D018810:Magnetic Resonance Angiography; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000601:surgery; D012086:Reoperation; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler
chemical_list: D000900:Anti-Bacterial Agents; D003287:Contrast Media