2141. Characteristics and prognosis of patients with a prosthetic vascular graft infection (PVGI): a prospective cohort of 200 patients.
Session: Poster Abstract Session: Healthcare Epidemiology: Surgical Site Infections
Saturday, October 6, 2018
Room: S Poster Hall
Background:

The aim of the present study was to describe the characteristics and prognosis of patients admitted for a PVGI and to assess the factors associated with the death of these patients.

Methods:

All consecutive patients admitted in our department between January 1, 2000 and January 1, 2018 for a PVGI were enrolled in the present prospective cohort study. PVGIs were divided into extracavitary (femoro-femoral, femoro-popliteal and axillo-femoral) and cavitary (aorto-iliac, aorto-femoral, ilio-femoral, aortic); into “early” infection (<4 months) and late. Patients’ baseline characteristics and their follow-up were described, and factors associated with death were assessed by using a logistic multivariate regression model.

Results: Overall, 200 patients were included during this period. The median age of patients was 69 years [IQR: 61-78], mainly of men (86%). One hundred and sixteen patients had an intracavitary PVGI (58%). Enterobacteriaceae and MSSA were the most frequent pathogens (n=60 and 59), followed by coagulase negative staphylococci (n=30), Streptococcus (n=26) and enterococcus (n=25). Surgery with replacement of the infected prosthesis was performed in 102 patients (53%). Culture of material samples taken during surgery were plurimicrobial in 67 patients (34%). After surgery, the median follow-up of patients was 7.5 months [IQR: 2-19] during which 30 presented a failure (15%) and 85 patients died, 41 due to the PVGI (21%). Factors independently associated with death in multivariate analysis were: to be over 70 years old (OR=8.2; p<0.01), to stay in ICU for more than 6 days (OR=5.9; p=0.01) and to have an intracavitary PVGI (OR=9.0; p=0.02). Antibiotic therapy regimen combining rifampicin to another antibiotic was associated with a decreased mortality (OR=0.11; p<0.01).

Conclusion:

Our results suggest that the prognostic of patients admitted for PVGI depends on the site of infection and the occurrence of a shock after the admission. We found a better prognosis for patients with an extracavitary PVGI, without sepsis. Finally, PVGI treated with an antibiotic combination including rifampicin had a better outcome.

Armelle Pasquet, MD1, Olivier Robineau, MD2, Michel Valette, MD3, Pier-Vito D'Elia, MD4, Sylvie Vandamme, CST2, Olivier Leroy, MD5, Barthelemy Lafon-Desmurs, MD3 and Eric Senneville, MD, PhD6, (1)Infectious Diseases, DRON hospital, tourcoing, France, (2)Infectious Diseases, Dron hospital, tourcoing, France, (3)Infectious Diseases, Dron Hospital, tourcoing, France, (4)Vascular Surgery, Dron hospital, tourcoing, France, (5)ICU, Dron Hospital, Tourcoing, France, (6)Infectious Diseases, Dron Hospital, Tourcoing, France

Disclosures:

A. Pasquet, None

O. Robineau, None

M. Valette, None

P. V. D'Elia, None

S. Vandamme, None

O. Leroy, None

B. Lafon-Desmurs, None

E. Senneville, None

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