Prior Use of Antibiotics and Immunosuppression Are Risk Factors for Fracture-related Infection During the COVID-19 Pandemic Period: a Brazilian Prospective Cohort Study

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2022 Jun 6

PMID 35658853

Authors

Eduardo Cezar Santos

Stefania Prebianchi

Ingrid Nayara Santos

Mariana Neri Kurihara

Adriana DellAquila

Carlos Finelli

Fernando Baldy Dos Reis

Mauro Jose Salles

Affiliations

Soon will be listed here.

Abstract

Background: Little is known about the role of COVID-19 pandemic period on the epidemiology of fracture-related infection (FRI). The present study summarizes the changes in the prevalence, microbiology, and risk factors of FRI during this period.

Methods: A prospective single-center cohort study assessed in the setting of COVID-19 pandemic (2020-2021), clinical, microbiological aspects, and independent risk factors (RF) of FRI. RFs were estimated by bivariate and multivariable analyses using prevalence ratio (PR) with significance at P < 0.05. Kaplan-Meier analysis was performed to evaluate treatment outcomes.

Results: Overall, 132 patients were analyzed, with patients with age over 65 years accounting 65.1%. FRI was diagnosed in 21(15.9%) patients. Independent RFs for FRI were recent and preoperative use of systemic antibiotics (PR: 7.0, 95% confidence interval (95% CI): 2.2 - 22.4, p = 0.001) and cancer (PR: 9.8, 95% CI: 2.0 - 48.8, p = 0.005). Cultures yielded Gram-negative bacteria in 77.8%, 33.3% were MDR.

Conclusions: We found higher rates of FRI, predominating in the elderly with closed femoral fractures during the COVID-19 pandemic. Prior use of antibiotics and immunosuppression conditions were independent factor for FRI. Our outcomes provide evidence to avoid the empirical use of antibiotics prior to surgery for fracture stabilization.

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