Role of asymptomatic bacteriuria on early periprosthetic joint infection after hip hemiarthroplasty. BARIFER randomized clinical trial,European Journal of Clinical Microbiology & Infectious Diseases

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Role of asymptomatic bacteriuria on early periprosthetic joint infection after hip hemiarthroplasty. BARIFER randomized clinical trial
European Journal of Clinical Microbiology & Infectious Diseases ( IF 4.5 ) Pub Date : 2021-04-16 , DOI: 10.1007/s10096-021-04241-2
Dolors Rodríguez-Pardo _{1,

2,

3} , María Dolores Del Toro _{2,

3,

4} , Laura Guío-Carrión _{2,

3,

5} , Rosa Escudero-Sánchez _{3,

6} , Marta Fernández-Sampedro _{2,

3,

7} , Miguel Ángel García-Viejo _{3,

8} , María Velasco-Arribas _{3,

9} , Laura Soldevila-Boixader _{3,

10} , Magdalena Femenias ₁₁ , José Antonio Iribarren _{3,

12} , María Del Carmen Pulido-Garcia ₁₃ , María Dolores Navarro _{2,

3,

4} , Mayli Lung _{2,

3,

14} , Pablo S Corona _{2,

3,

15} , Benito Almirante _{1,

2,

3} , Carles Pigrau _{1,

2,

3}

Affiliation

Infectious Diseases Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0003), Instituto de Salud Carlos III, Madrid, Spain.
Study Group on Osteoarticular Infections of the Spanish Society of Clinical Microbiology and Infectious Diseases (GEIO-SEIMC), Madrid, Spain.
Infectious Diseases Unit, Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain.
Infectious Diseases Department, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain.
Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Infectious Diseases Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
Internal Medicine Department (Infectious Diseases Division), Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Infectious Diseases Department, Hospital Universitari de Bellvitge, Barcelona, Spain.
Orthopedic Surgery Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
Infectious Diseases Department, Hospital Universitario Donostia IIS Biodonostia, San Sebastián, Spain.
Orthopedic Surgery Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
Septic and Reconstructive Surgery Unit, Orthopedic Surgery Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.

Purpose

To evaluate preoperative asymptomatic bacteriuria (ASB) treatment to reduce early-periprosthetic joint infections (early-PJIs) after hip hemiarthroplasty (HHA) for fracture.

Methods

Open-label, multicenter RCT comparing fosfomycin-trometamol versus no intervention with a parallel follow-up cohort without ASB. Primary outcome: early-PJI after HHA.

Results

Five hundred ninety-four patients enrolled (mean age 84.3); 152(25%) with ASB (77 treated with fosfomycin-trometamol/75 controls) and 442(75%) without. Despite the study closed without the intended sample size, ASB was not predictive of early-PJI (OR: 1.06 [95%CI: 0.33–3.38]), and its treatment did not modify early-PJI incidence (OR: 1.03 [95%CI: 0.15–7.10]).

Conclusions

Neither preoperative ASB nor its treatment appears to be risk factors of early-PJI after HHA. ClinicalTrials.gov Identifier: Eudra CT 2016-001108-47

中文翻译：

无症状菌尿在髋关节置换术后早期假体周围关节感染中的作用。BARIFER 随机临床试验

目的

评估术前无症状菌尿 (ASB) 治疗以减少髋关节半髋置换术 (HHA) 骨折后早期假体周围关节感染 (early-PJI)。

方法

开放标签、多中心 RCT 比较磷霉素-氨丁三醇与无干预与无 ASB 的平行随访队列。主要结果：HHA 后的早期 PJI。

结果

招募了 594 名患者（平均年龄 84.3 岁）；152 (25%) 名使用 ASB（77 名使用磷霉素-氨丁三醇治疗/75 名对照）和 442 名（75%）未使用。尽管研究在没有预期样本量的情况下结束，但 ASB 不能预测早期 PJI（OR：1.06 [95%CI：0.33-3.38]），并且其治疗没有改变早期 PJI 的发生率（OR：1.03 [95% CI：0.15–7.10]）。