To define the outcome predictors of Candida prosthetic joint infections (CPJI) through a systematic review and meta-analysis, highlighting their clinical significance.
Key Findings:
Polymicrobial infections accounted for 33% of cases.
Candida albicans was the predominant species (47.2%), followed by Candida parapsilosis (28.6%).
Co-infection with Staphylococcus aureus and debridement/retention of the prosthesis were independent predictors of treatment failure (P < .001).
First-line therapy with amphotericin B was associated with treatment success (P = .014).
No significant difference was found based on the type of prosthesis exchange procedure.
Interpretation:
The study highlights the critical role of complete hardware removal in CPJI management and supports the use of amphotericin B as initial antifungal therapy, suggesting implications for clinical practice.
Limitations:
The study's findings are based on a limited number of cases and may not be generalizable.
The heterogeneity of included studies may affect the robustness of the conclusions, particularly in treatment protocols.
Conclusion:
This comprehensive review provides evidence for the management of CPJI, emphasizing the importance of surgical intervention and specific antifungal therapy, and calls for further research to establish standardized guidelines.
