Program Schedule

694
Bone and joint infection due to bacteria producing Extended Broad Spectrum Beta lactamase

Session: Poster Abstract Session: Approach to Clinical Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background:

Bone and joint infection due to bacteria producing Extended Broad Spectrum Beta lactamase (ESBL) are rare but rising nowadays. Data on this disease are scarce and outcome is not well known. We present a cohort of 43 cases

Methods:

Multicentric retrospective cohort of consecutive cases of bone and joint infection due to ESBL producing microorganism identified from the charts of the microbiology laboratory. Case definition needs at least one per operative sample positive to ESBL producing microorganism and a medical and surgical management for a bone and joint infection. We collected from the medical charts : epidemiologic characteristics, disease history, management and outcome.

Results: Fourty three bone and joint infections due to ESBL producing microorganisms were identified, 34 were men, mean age was 56 years old, 10 were immunosuppressed. Ten patients recently travelled in foreign countries.

The infection was hematogenous in only 1 case.

Type of infection were : articular device (n=28), osteitis (n=7), arthritis (n=7).

In 23 cases it was not the first surgery on the site. Eleven infections were considered as acute. Most frequent involved bacteria were Enterobacter spp. (n=14), Escherichia coli (n=13), Klebsiella spp. (n=13), Proteus spp. (n=4).

Infections were polymicrobial in 27 cases, one was associated with bacteriemia.

Carbapenem was the antibiotic prescription in39 cases. Switch or extraction of the device was performed in 16 cases.

Outcome was defavourable in 20 cases : septic failure  with new indication for surgery and two deaths.

 Conclusion:

Bone and joint infections due to ESBL producing microorganisms occur in patients with important co morbidities and a history of surgery ; their outcome is frequently severe.

Claire Rouzaud1, Guillaume Mellon2, Thomas Bauer3, Beate Heym4, Anne-Laure Roux2, Thierry Judet1, Christian Perronne5 and Aurelien Dinh, MD6, (1)University hospital of Paris, Garches, France, (2)University Hospital of Paris, Garches, France, (3)University Hospital of Paris, Boulogne, France, (4)University Hospital of Paris, 92500, France, (5)university hospital of Paris, Garches, France, (6)Infectious Disease, University Hospital, Garches, France

Disclosures:

C. Rouzaud, None

G. Mellon, None

T. Bauer, None

B. Heym, None

A. L. Roux, None

T. Judet, None

C. Perronne, None

A. Dinh, None

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