Vascular graft infections in the intensive care unit: Clinical spectrum and prognostic factors

Szczot, Magdalena; Meybeck, Agnès; Legout, L.; Pasquet, A.; Grunderbeeck, Nicolas Van; Langlois, Joachim; Sarraz-Bournet, Béatrice; Devos, Patrick; Leroy, Olivier

doi:10.1016/j.jinf.2010.12.006

Cited by 23 publications

(17 citation statements)

References 27 publications

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“…The impact of their use on mortality varies: one study found no benefit of aminoglycosides on mortality rates Page 11 of 64 A c c e p t e d M a n u s c r i p t 11 [41], whereas a separate study found that aminoglycosides might reduce mortality when used for patients in intensive care (59% vs. 27%; P = 0.07 in multivariate analysis) [42].…”

Section: Gram-negative Bacillimentioning

confidence: 99%

Medical treatment of prosthetic vascular graft infections: Review of the literature and proposals of a Working Group

Revest¹,

Camou²,

Senneville³

et al. 2015

International Journal of Antimicrobial Agents

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More than 400000 vascular grafts are inserted annually in the USA. Graft insertion is complicated by infection in 0.5-4% of cases. Vascular graft infections (VGIs) are becoming one of the most frequent prosthesis-related infections and are associated with considerable mortality, ranging from 10 to 25% within 30 days following the diagnosis. Treatment of VGI is based on urgent surgical removal of the infected graft followed by prolonged antibiotherapy. Data regarding the best antibiotherapy to use are lacking since no well designed trial to study antimicrobial treatment of VGI exists. Moreover, since VGIs demonstrate very specific pathophysiology, guidelines on other material-related infections or infective endocarditis treatment cannot be entirely applied to VGI. A French multidisciplinary group gathering infectious diseases specialists, anaesthesiologists, intensivists, microbiologists, radiologists and vascular surgeons was created to review the literature dealing with VGI and to make some proposals regarding empirical and documented antibiotic therapy for these infections. This article reveals these proposals.

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Section: Gram-negative Bacillimentioning

confidence: 99%

Medical treatment of prosthetic vascular graft infections: Review of the literature and proposals of a Working Group

Revest¹,

Camou²,

Senneville³

et al. 2015

International Journal of Antimicrobial Agents

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“…They demonstrated the high rates of morbidity and mortality associated with VGI and suggested that early intervention, which includes an aminoglycoside may be protective. 1 Given the surgical nature of VGI, research in the area often views microbial characterisation and its therapy as an adjunct when reporting findings. 1 Therefore, there remains a paucity of data available to guide decisions on appropriate antimicrobial treatment 2 despite calls for greater characterisation of the microbiology of VGI.…”

Section: Microbiological Characterisation Of Prosthetic Vascular Grafmentioning

confidence: 99%

“…1 Given the surgical nature of VGI, research in the area often views microbial characterisation and its therapy as an adjunct when reporting findings. 1 Therefore, there remains a paucity of data available to guide decisions on appropriate antimicrobial treatment 2 despite calls for greater characterisation of the microbiology of VGI. 1e3 We aimed to investigate whether different causative micro-organisms influence management decisions or outcomes of treatment within our cohort of VGI patients.…”

Section: Microbiological Characterisation Of Prosthetic Vascular Grafmentioning

confidence: 99%

Microbiological characterisation of prosthetic vascular graft infection

Rawson

Lee

Khanna

et al. 2015

Journal of Infection

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“…Infection of the prosthetic vascular graft is a rare but severe complication (1)(2)(3)(4). Death rates after vascular prosthetic graft infection range from 15% to 75%, amputation in up to 70% of cases, and reinfection in approximately 18% of patients (5)(6)(7)(8)(9)(10). The risk of complications increases with delayed treatment, which occurs often as a result of failure to diagnose, mainly in cases with a subtle, nonspecific clinical presentation.…”

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confidence: 99%

¹⁸F-FDG Uptake in Noninfected Prosthetic Vascular Grafts: Incidence, Patterns, and Changes over Time

et al. 2014

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18 F-FDG PET/CT is of value in the diagnosis of prosthetic vascular graft infection, but potential pitfalls related to tracer uptake in noninfected implants have been described. The current study assesses the incidence and patterns of 18 F-FDG uptake over time in noninfected grafts, in relationship to prosthetic material and location. Methods: A 12-y PET/CT database was retrospectively searched for cancer patients with prosthetic vascular grafts. Data retrieved from patient files included graft location, material, and time from surgery. Images were reviewed by 2 nuclear medicine physicians in consensus, with the presence and patterns (focal, diffuse homogeneous, inhomogeneous) of increased 18 F-FDG uptake in grafts recorded. The mean standardized uptake value in grafts (SUV-G) and mediastinum (SUV-M) was measured. The ratio of SUV-G to SUV-M (SUV-G/SUV-M) was calculated for each graft. Results: One hundred seven prostheses were identified in 102 studies in 43 cancer patients. Sixty-seven prostheses were made of Dacron, 33 of Gore-Tex, and 7 were native veins. No increased 18 F-FDG uptake was found in 9 grafts (native veins, 4; Gore-Tex, 3; Dacron, 2). There was diffuse homogeneous uptake in 68 and inhomogeneous uptake in 30 grafts. The homogeneous pattern was more prevalent in Gore-Tex whereas the inhomogeneous uptake was seen more in Dacron vascular grafts. None of the grafts demonstrated focal uptake. The SUV-G range was 0.4-6.3 (average, 1.9), and SUV-M range was 0.6-2.4 (average, 1.4). The intensity of uptake was significantly higher in Dacron (SUV-G 5 2.35 and SUV-G/ SUV-M 5 1.72) than in Gore-Tex (SUV-G 5 1.09, SUV-G/SUV-M 5 0.91) and native vein grafts (SUV-G 5 1.07, SUV-G/SUV-M 5 0.75) (P , 0.005). Native vein grafts showed a significant decrease in 18 F-FDG uptake over time whereas synthetic grafts showed no change in intensity for a follow-up of up to 16 y. Conclusion: Diffuse 18 F-FDG uptake was found in 92% of noninfected vascular prostheses, more in Dacron grafts than with other materials. The intensity of 18 F-FDG uptake of synthetic grafts did not change over time. With knowledge of the presence, patterns, and persistence of 18 F-FDG uptake in noninfected vascular prostheses, misinterpretation of PET/CT studies in patients referred for suspected prosthetic infection and in those assessed for diseases unrelated to their graft status can be avoided.

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Vascular graft infections in the intensive care unit: Clinical spectrum and prognostic factors

Cited by 23 publications

References 27 publications

Medical treatment of prosthetic vascular graft infections: Review of the literature and proposals of a Working Group

Medical treatment of prosthetic vascular graft infections: Review of the literature and proposals of a Working Group

Microbiological characterisation of prosthetic vascular graft infection

¹⁸F-FDG Uptake in Noninfected Prosthetic Vascular Grafts: Incidence, Patterns, and Changes over Time

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Vascular graft infections in the intensive care unit: Clinical spectrum and prognostic factors

Cited by 23 publications

References 27 publications

Medical treatment of prosthetic vascular graft infections: Review of the literature and proposals of a Working Group

Medical treatment of prosthetic vascular graft infections: Review of the literature and proposals of a Working Group

Microbiological characterisation of prosthetic vascular graft infection

18F-FDG Uptake in Noninfected Prosthetic Vascular Grafts: Incidence, Patterns, and Changes over Time

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¹⁸F-FDG Uptake in Noninfected Prosthetic Vascular Grafts: Incidence, Patterns, and Changes over Time