{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:12:19Z","timestamp":1753877539005,"version":"3.41.2"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T00:00:00Z","timestamp":1650153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We aimed to describe the management and treatment of hip joint infections caused by multidrug-resistant Enterobacterales among patients with spinal cord injury (SCI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included all hip joint infections associated with grade IV decubitus ulcers caused by extended-spectrum beta-lactamase producing Enterobacterales (ESBL-PE) and carbapenemase-producing Enterobacterales treated in a reference center for bone and joint infections over 9 years in a retrospective study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventeen SCI patients with ischial pressure ulcers breaching the hip capsule (mean age 52\u2009\u00b1\u200915 years) were analyzed. In 16 patients, paraplegia was secondary to trauma and 1 was secondary to multiple sclerosis. Infections were mostly polymicrobial (n\u2009=\u200915; 88.2%), notably caused by Klebsiella pneumoniae (n\u2009=\u200910) and Staphylococcus aureus (n\u2009=\u200910). The carbapenemases identified were exclusively OXA-48-type (n\u2009=\u20093) including 2 isolates coexpressed with ESBL-PE within the same bacterial host. Multidrug-resistant Enterobacterales were commonly resistant to fluoroquinolones (n\u2009=\u200912; 70.6%). Most therapies were based on carbapenems (n\u2009=\u200910) and combination therapies (n\u2009=\u200913). Median duration of treatment was 45 (6\u201360) days. Of 17 cases of hip joint infections, 94.1% (n\u2009=\u200916) benefited from a femoral head and neck resection. Infection control was initially achieved in 58.8% (n\u2009=\u200910) of cases and up to 88.2% after revision surgeries, after a median follow-up of 3 (1\u201336) months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Hip infections among SCI patients caused by multidrug-resistant Enterobacterales are often polymicrobial and fluoroquinolones-resistant infections caused by Klebsiella pneumoniae and S aureus, highlighting the need for expert centers with pluridisciplinary meetings associating experienced surgeons, clinical microbiologists, and infectious disease specialists.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofac209","type":"journal-article","created":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T12:11:36Z","timestamp":1650197496000},"source":"Crossref","is-referenced-by-count":1,"title":["Hip Joint Infections Caused by Multidrug-Resistant Enterobacterales Among Patients With Spinal Cord Injury: Experience of a Reference Center in the Greater Paris Area"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2859-8417","authenticated-orcid":false,"given":"B","family":"Davido","sequence":"first","affiliation":[{"name":"Service des Maladies Infectieuses, Universit\u00e9 Paris-Saclay, H\u00f4pital Raymond Poincar\u00e9, Assistance-Publique des H\u00f4pitaux de Paris , Garches , France"},{"name":"UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Sant\u00e9 , Montigny le Bx , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Noussair","sequence":"additional","affiliation":[{"name":"Laboratoire de Microbiologie, Universit\u00e9 Paris-Saclay, H\u00f4pital Raymond Poincar\u00e9, Assistance-Publique Des H\u00f4pitaux De Paris , Garches , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"El Sayed","sequence":"additional","affiliation":[{"name":"Laboratoire de Microbiologie, Universit\u00e9 Paris-Saclay, H\u00f4pital Ambroise Par\u00e9, Assistance-Publique des H\u00f4pitaux de Paris , Boulogne-Billancourt , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Jaffal","sequence":"additional","affiliation":[{"name":"Service des Maladies Infectieuses, Universit\u00e9 Paris-Saclay, H\u00f4pital Raymond Poincar\u00e9, Assistance-Publique des H\u00f4pitaux de Paris , Garches , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Le Liepvre","sequence":"additional","affiliation":[{"name":"Medecine Physique et reeducation, Universit\u00e9 Paris-Saclay, H\u00f4pital Raymond Poincar\u00e9, Assistance-Publique des H\u00f4pitaux de Paris , Garches , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Marmouset","sequence":"additional","affiliation":[{"name":"Service d\u2019Orthop\u00e9die, Universit\u00e9 Paris-Saclay, H\u00f4pital Ambroise Par\u00e9, Assistance-Publique des H\u00f4pitaux de Paris , Boulogne-Billancourt , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Bauer","sequence":"additional","affiliation":[{"name":"Service d\u2019Orthop\u00e9die, Universit\u00e9 Paris-Saclay, H\u00f4pital Ambroise Par\u00e9, Assistance-Publique des H\u00f4pitaux de Paris , Boulogne-Billancourt , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J L","family":"Herrmann","sequence":"additional","affiliation":[{"name":"UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Sant\u00e9 , Montigny le Bx , France"},{"name":"Laboratoire de Microbiologie, Universit\u00e9 Paris-Saclay, H\u00f4pital Raymond Poincar\u00e9, Assistance-Publique Des H\u00f4pitaux De Paris , Garches , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Rottman","sequence":"additional","affiliation":[{"name":"UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Sant\u00e9 , Montigny le Bx , France"},{"name":"Laboratoire de Microbiologie, Universit\u00e9 Paris-Saclay, H\u00f4pital Raymond Poincar\u00e9, Assistance-Publique Des H\u00f4pitaux De Paris , Garches , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A C","family":"Cremieux","sequence":"additional","affiliation":[{"name":"UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Sant\u00e9 , Montigny le Bx , France"},{"name":"Service de Maladies Infectieuses, Universit\u00e9 Paris Nord, H\u00f4pital Saint-Louis, Assistance-Publique des H\u00f4pitaux de Paris , Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Saleh-Mghir","sequence":"additional","affiliation":[{"name":"Service des Maladies Infectieuses, Universit\u00e9 Paris-Saclay, H\u00f4pital Raymond Poincar\u00e9, Assistance-Publique des H\u00f4pitaux de Paris , Garches , France"},{"name":"UMR UVSQ INSERM U1173, UFR 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