International Organism Profile of Periprosthetic Total Hip and Knee Infections

Villa, Jesus M.; Pannu, Tejbir S.; Theeb, Ibrahim; Buttaro, Martín; Oñativia, José Ignacio; Carbó, Lisandro; Rienzi, Daniel; Fregeiro, José; Корнилов, Николай Николаевич; Божкова, С. А.; Sandiford, Nemandra A; Piuzzi, Nicolás S.; Kendoff, Daniel

doi:10.1016/j.arth.2020.07.020

Cited by 28 publications

(22 citation statements)

References 10 publications

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“…A European study focused on PJI caused by enterococcus spp identi ed 107 polymicrobial PJI cases out of 203 patients [13]. An American study focused on PJI pathogens had comparable results [14,15]. Despite relatively small sample size, our results are in accordance with their observations.…”

Section: Resultssupporting

confidence: 88%

Specific pathogens indicate higher risk of polymicrobial periprosthetic joint infection: a single-center retrospective study

Li¹,

Jiang²,

Chen³

2020

Preprint

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Background Polymicrobial periprosthetic joint infection is a subset of periprosthetic joint infection and indicates disastrous outcomes. However, the incidence of polymicrobial PJI can be underestimated so we perform a single-center retrospective study with an intention to predict the incidence of polymicrobial PJI based on culture results. Materials and methods Medical records about 153 patients with PJI between 2017/1/1 and 2018/12/31 in a joint center were selected retrospectively. Multivariable analysis was utilized to evaluate the association between various pathogens and polymicrobial PJI. Result Staphylococcus aureus (OR:3.83, 95%CI(1.30,11.27), p-value = 0.015 ), coagulase negative staphylococci (OR: 2.68 ,95%CI: (1.10, 6.25), p-value = 0.028), Enterococcus spp (OR:6.46;95%CI(1.35,30.87),P-value = 0.020)andStreptococcusspp(OR:19.38, 95%CI:(3.57,105.21), p-value = 0.001) indicate higher risk of polymicrobial pathogens compared with other pathogens Conclusion Streptococcus spp and Enterococcus spp are associated with higher risk of polymicrobial PJI and more pathogens are like to be found in additional culture when these pathogens are detected by a single culture.

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Section: Resultssupporting

confidence: 88%

Specific pathogens indicate higher risk of polymicrobial periprosthetic joint infection: a single-center retrospective study

Li¹,

Jiang²,

Chen³

2020

Preprint

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“…We have observed that the percentage of polymicrobial PJI in culture-positive PJI is about 28.82% and it is consistent with previous reports [10].…”

Section: Discussionsupporting

confidence: 93%

The Risk Factors of Polymicrobial Periprosthetic Joint Infection: A Single-Center Retrospective Cohort Study.

Chai

et al. 2021

Preprint

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BackgroundPeriprosthetic joint infection is a serious complication after total joint arthroplasty and polymicrobial PJI which compose a subtype of PJI often indicate worse outcomes compared to monomicrobial periprosthetic joint infection. However, a literature review suggested that there were limited number studies evaluating the risk factors of polymicrobial PJI. Materials and methodsBetween 2015 January and 2019 December, a total of 64 polymicrobial PJI patients and 158 monomicrobial PJI patients in a tertiary center were included in this study and corresponding medical records were scrutinized. The diagnosis of PJI was based on 2014 MSIS criteria. Logistic regression was used to identify the association between various variables and polymicrobial PJI and ROC curve was used to identify their efficiency. ResultsThe prevalence of polymicrobial PJI is about 28.28% in our cohorts. After adjusting, the presence of previous revisions (OR, 1.93; p < 0.01), isolation of enterococci (OR, 11.36; p < 0.01), isolation of Escherichia coli (OR, 6.55; p < 0.01), infection with atypical organisms (OR, 9.85; p < 0.01), infection with gram-negative organisms (OR, 6.33; p < 0.01), isolation of streptococcus spp (OR, 1.93; p < 0.01), and infection with CNS (OR, 1.93; p < 0.01) were risk factors of polymicrobial PJI compared to monomicrobial PJI. However, knee infection is a protection factor of polymicrobial PJI with an adjusted OR=0.0479 (p=0.023). ConclusionThis study demonstrated that the prevalence of polymicrobial PJI is about 28.28% in culture-positive PJI patients. Moreover, the presence of sinus tract and previous joint revisions were risk factors for identifying different bacterial species in the intraoperative specimens. Therefore, in these PJI cases, it is necessary to examine multiple specimens of both intraoperative tissue and synovial fluid for increasing the detection rate and obtaining resistance information.

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“…Polymicrobial PJIs accounted for 10.5 to 19% of THA PJIs and 9 to 12.3% of TKA PJIs in previous studies [ 3 ]. We have observed that the percentage of polymicrobial PJI in culture-positive PJI is about 28.8% and it is consistent with previous reports [ 11 ].…”

Section: Discussionsupporting

confidence: 93%

The risk factors of polymicrobial periprosthetic joint infection: a single-center retrospective cohort study

Niu

et al. 2021

BMC Musculoskelet Disord

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Background Periprosthetic joint infection is a serious complication after total joint arthroplasty and polymicrobial PJI which compose a subtype of PJI often indicate worse outcomes compared to monomicrobial periprosthetic joint infection. However, a literature review suggested that there were limited number studies evaluating the risk factors of polymicrobial PJI. Materials and methods Between 2015 January and 2019 December, a total of 64 polymicrobial PJI patients and 158 monomicrobial PJI patients in a tertiary center were included in this study and corresponding medical records were scrutinized. The diagnosis of PJI was based on 2014 MSIS criteria. Logistic regression was used to identify the association between various variables and polymicrobial PJI and ROC curve was used to identify their efficiency. Results The prevalence of polymicrobial PJI is 28.3% in our cohorts. After adjusting for the presence of sinus, previous and knee infection, isolation of enterococci (OR, 3.025; 95%CI (1.277,7.164) p = 0.012), infection with atypical organisms (OR, 5.032;95%CI: (1.470,17.229) p = 0.01), infection with gram-negative organisms (OR, 2.255; 95%CI (1.011,5.031) p = 0.047), isolation of streptococcus spp. (OR, 6; 95%CI (2.094,17.194) p = 0.001), and infection with CNS (OfR, 2.183;95%CI (1.148,4.152) p = 0.017) were risk factors of polymicrobial PJI compared to monomicrobial PJI. However, knee infection is related to a decreased risk of polymicrobial PJI with an adjusted OR = 0.479 (p = 0.023). Conclusion This study demonstrated that the prevalence of polymicrobial PJI is 28.3% in PJI patients. Moreover, the presence of sinus tract and previous joint revisions were risk factors for identifying different bacterial species in the intraoperative specimens. Therefore, in these PJI cases, it is necessary to examine multiple specimens of both intraoperative tissue and synovial fluid for increasing the detection rate and obtaining resistance information.

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International Organism Profile of Periprosthetic Total Hip and Knee Infections

Cited by 28 publications

References 10 publications

Specific pathogens indicate higher risk of polymicrobial periprosthetic joint infection: a single-center retrospective study

Specific pathogens indicate higher risk of polymicrobial periprosthetic joint infection: a single-center retrospective study

The Risk Factors of Polymicrobial Periprosthetic Joint Infection: A Single-Center Retrospective Cohort Study.

The risk factors of polymicrobial periprosthetic joint infection: a single-center retrospective cohort study

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