Use of rifampicin and graft removal are associated with better outcomes in prosthetic vascular graft infection

Anne Coste (1) , Mélanie Poinot (2) , Sophie Panaget (1) , Bénédicte Albert (1) , Adrien Kaladji (3, 2) , Hervé Le Bars (1) , Nasr Bahaa (1) , Badra Ali (1) , Caroline Piau (2) , Vincent Cattoir (4, 2) , Claire de Moreuil (1) , Matthieu Revest (4, 2, 5) , Rozenn Le Berre (6)

1 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
2 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
3 LTSI - Laboratoire Traitement du Signal et de l'Image
4 BRM - ARN régulateurs bactériens et médecine
5 CIC - Centre d'Investigation Clinique [Rennes]
6 GGB - Génétique, génomique fonctionnelle et biotechnologies (UMR 1078)

OBJECTIVES: Prosthetic vascular graft infection (PVGI) is a very severe disease. We aimed to determine the factors associated with treatment failure. METHODS: Patients admitted to two University Hospitals with PVGI were included in this retrospective study. PVGI was classified as possible, probable or proven according to an original set of diagnostic criteria. We defined treatment failure if one of the following events occurred within the first year after PVGI diagnosis: death and infection recurrence due to the same or another pathogen. RESULTS: One hundred and twelve patients were diagnosed with possible (n = 26), probable (n = 22) and proven (n = 64) PVGI. Bacterial documentation was obtained for 81% of patients. The most frequently identified pathogen was Staphylococcus aureus (n = 39). Surgery was performed in 96 patients (86%). Antibiotics were administered for more than 6 weeks in 41% of patients. Treatment failure occurred in 30 patients (27.5%). The factors associated with a lower probability of treatment failure were total removal of the infected graft (OR = 0.2, 95% CI [0.1-0.6]), rifampicin administration (OR = 0.3 [0.1-0.9]) and possible PVGI according to the GRIP criteria (OR = 0.3 [0.1-0.9]). CONCLUSIONS: Treatment failure occurred in 27.5% of patients with PVGI. Total removal of the infected graft and rifampicin administration were associated with better outcomes.

Mots clés: Rifampicin; Staphylococcus aureus; Vascular prosthesis infection

Domaines: Ingénierie biomédicale; Maladies infectieuses; Cardiologie et système cardiovasculaire

Anne Coste, Mélanie Poinot, Sophie Panaget, Bénédicte Albert, Adrien Kaladji, et al.. Use of rifampicin and graft removal are associated with better outcomes in prosthetic vascular graft infection. Infection, 2021, 49 (1), pp.127-133. ⟨10.1007/s15010-020-01551-z⟩. ⟨hal-03101608⟩