Factors affecting the course and prognosis of implant-associated infection caused by Klebsiella spp.

Abstract

Background. The outcome of complex treatment of implant-associated infection (IAI) depends on various factors, but one of the most important is the etiology of the inflammatory process. Treatment of orthopedic infection caused by gram-negative microorganisms in general and representatives of the Enterobacteria family in particular causes many difficulties, one of which is the rapid growth of antibiotic resistance. Aim of the stydy - to evaluate the factors affecting the course and prognosis of IAI caused by Klebsiella spp. Methods. A retrospective case history of 85 patients who were treated in the clinical departments of the center from January 1, 2017 to December 31, 2021 for the treatment of IAI caused by Klebsiella spp was performed. According to the results of the telephone survey, the patients were divided into 2 main groups depending on the outcome of the 2-year follow-up period determined according to the Delphi criteria. The groups were comparable in terms of gender, age and anthropometric data. Further, in the IBM SPSS STATISTICS program (version 26), a statistical analysis of the impact on the outcome of various parameters was carried out: anamnesis data, laboratory studies, type of surgical intervention, the course of the postoperative period, antibiotic therapy at the inpatient and outpatient stages. Results. During the studied period, it was found that the prognosis was significantly worsened by the number of sanitizing surgical interventions in the anamnesis (p=0.022), the need for sanitizing intervention in the early postoperative period (p0.001) and the presence of Klebsiella spp. growth in postoperative crops (p=0.002), hypoalbuminemia on 7-14 days after the operation (p=0.008). At the same time, the appointment of trimethoprim-sulfamethoxazole for the outpatient period significantly improved the outcome (p=0.038).