Is the prognosis the same for periprosthetic joint infections due to Staphylococcus aureus versus coagulase-negative staphylococci? A retrospective study of 101 patients with 2-year minimum follow-up

Abstract

III, retrospective case-control study.

Prosthetic Knee Infection With Coagulase-Negative Staphylococcus: A Harbinger of Poor Outcomes

“…This notion of an ongoing natural selection of more hostile CoNS is further supported by previously unexpected findings concerning the non-inferiority of MRSA outcomes when compared to CoNS sequelae in a small series of PJIs in contemporary literature [47,55,56]. This is in contrast to prior literature that found a greater incidence of treatment susceptibility in CoNS, such as Staphylococcus epidermidis, than in MRSA [26,57,58].…”

“…This is in contrast to prior literature that found a greater incidence of treatment susceptibility in CoNS, such as Staphylococcus epidermidis, than in MRSA [26,57,58]. Whereas pathogens such as MRSA have been traditionally feared as treatment resistant, with investigators recommending early and more invasive and aggressive intervention [38], the tendency toward rapid biofilm formation and antibiotic resistance acquisition in CoNS makes their behavior in the PJI setting fairly similar at present [55,56]. Our data supports this notion of an increasingly recalcitrant family of bacteria.…”

Differences in Diagnostic Properties Between Standard and Enrichment Culture Techniques Used in Periprosthetic Joint Infections

“…CoNS and SA are often responsible for PJI and are implicated in approximately 25% of cases [23e25]. Although SA has a higher intrinsic virulence than CoNS [26], Murgier et al [27] reported that the healing rate of SA PJI was similar to that of CoNS PJI, and that both must be treated with same degree of rigor. In addition, a recent study by Cunningham et al [28] showed that CoNS was the most common organism in PJI and was associated with an increased risk of additional surgery.…”

Two-stage revision arthroplasty for coagulase-negative staphylococcal periprosthetic joint infection of the hip and knee

“…Coagulase-negative staphylococci (CoNS) are a hard-to-treat group of microorganisms in relation to implanted foreign materials, due to a high rate of methicillin resistance and biofilm formation[1]. In recent years, the incidence of infections with CoNS has increased[2,3]. Periprosthetic joint infection (PJI) is a devastating complication after hip and knee arthroplasty that occurs in 1%-2% of patients[4].…”