Características microbiológicas y patrones de resistencia en infecciones de prótesis articular en un hospital de referencia

This in vitro study suggests that chlorhexidine may be a more effective irrigation solution for S epidermidis in biofilm than other commonly used solutions, such as povidone-iodine, Dakin's solution, and triple antibiotic solution. Clinical outcomes should be studied to determine the most effective antiseptic agent, concentration, and exposure time when intraoperative irrigation is used in the presence of biofilm.

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Chlorhexidine Antiseptic Irrigation Eradicates Staphylococcus epidermidis From Biofilm: An In Vitro Study

Schmidt

Estes

McLaren

et al. 2018

Clin Orthop Relat Res

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Genotypic and phenotypic changes of Staphylococcus epidermidis during relapse episodes in prosthetic joint infections

et al. 2019

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Orthopedic Implant-Associated Infection by Multidrug Resistant Enterobacteriaceae

Pfang

García-Cañete

García-Lasheras

et al. 2019

JCM

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Introduction: Orthopedic implant-associated infections caused by multidrug-resistant Enterobacteriaceae are a growing challenge for healthcare providers due to their increasing incidence and the difficulties of medical and surgical treatment. Material and Methods: A retrospective observational study of all cases of multidrug resistant Enterobacteriaceae orthopedic implant-associated infection diagnosed in a tertiary European hospital from December 2011 to November 2017 was carried out. Clinical records were reviewed using a previously designed protocol. Data analysis was performed with IBM® SPSS®, version 22. Results: 25 patients met inclusion criteria. The infected implants included 10 prosthetic joints, seven osteosyntheses, six combinations of prosthetic joint and osteosynthesis material, and two spacers. Of the multidrug resistant Enterobacteriaceae obtained on culture, 12 were extended-spectrum beta-lactamase-producing Escherichia coli, three OXA-48-producing Klebsiella pneumoniae, nine extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, and one extended-spectrum beta-lactamase-producing Proteus mirabilis. Combination antimicrobial therapy was employed in all cases but two. Overall, 16 (64%) patients underwent implant removal. The rate of infection control in the overall implant removal group was 100% compared to 33% in the implant retention group. A strong relationship between implant removal and infection control was observed (p = 0.001). Discussion: Implant removal is strongly associated with infection control. However, in some cases, patient age and comorbidity contraindicate hardware extraction. Potential objectives for future studies should be geared towards targeting the population in which debridement, antibiotic therapy, and implant retention can be used as a first-line therapeutic strategy with a reasonable probability of achieving infection control.

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Características microbiológicas y patrones de resistencia en infecciones de prótesis articular en un hospital de referencia

Abstract: The microbiological characteristics found in prosthetic joint infections vary according to the hospitals. In this series, a high proportion of coagulase-negative Staphylococci and Enterococcus spp. were found, as well as a high bacterial resistance.

Cited by 3 publications

References 38 publications

Chlorhexidine Antiseptic Irrigation Eradicates Staphylococcus epidermidis From Biofilm: An In Vitro Study

Chlorhexidine Antiseptic Irrigation Eradicates Staphylococcus epidermidis From Biofilm: An In Vitro Study

Genotypic and phenotypic changes of Staphylococcus epidermidis during relapse episodes in prosthetic joint infections

Orthopedic Implant-Associated Infection by Multidrug Resistant Enterobacteriaceae

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