Microbiological Aetiology, Epidemiology, and Clinical Profile of Prosthetic Joint Infections: Are Current Antibiotic Prophylaxis Guidelines Effective?

Abstract

<jats:title>ABSTRACT</jats:title><jats:p>Prosthetic joint infections remain a major complication of arthroplasty. At present, local and international guidelines recommend cefazolin as a surgical antibiotic prophylaxis at the time of arthroplasty. This retrospective cohort study conducted across 10 hospitals over a 3-year period (January 2006 to December 2008) investigated the epidemiology and microbiological etiology of prosthetic joint infections. There were 163 cases of prosthetic joint infection identified. From a review of the microbiological culture results, methicillin-resistant<jats:named-content xmlns:xlink="http://www.w3.org/1999/xlink" content-type="genus-species" xlink:type="simple">Staphylococcus aureus</jats:named-content>(MRSA) and coagulase-negative staphylococci were isolated in 45% of infections. In addition, polymicrobial infections, particularly those involving Gram-negative bacilli and enterococcal species, were common (36%). The majority (88%) of patients received cefazolin as an antibiotic prophylaxis at the time of arthroplasty. In 63% of patients in this cohort, the microorganisms subsequently obtained were not susceptible to the antibiotic prophylaxis administered. The results of this study highlight the importance of ongoing reviews of the local ecology of prosthetic joint infection, demonstrating that the spectrum of pathogens involved is broad. The results should inform empirical antibiotic therapy. This report also provokes discussion about infection control strategies, including changing surgical antibiotic prophylaxis to a combination of glycopeptide and cefazolin, to reduce the incidence of infections due to methicillin-resistant staphylococci.</jats:p>

Treatment Options and Outcomes of Vancomycin-Resistant Enterococcus in prosthetic joint infections: Case Report and Potential Implications for Military Cases

“…A one-stage revision with placement of Hickman catheters allows for higher rates of microbiologic cure, characterized by negative follow-up synovial fluid cultures in patients with susceptible pathogens (3). Most significantly, the use of catheters supplying intraarticular antibiotics allows possible improvement of arthroplasty salvage rates and less limb loss, as compared to more traditional twostage revision (3,(19)(20)(21).…”

Selective etching of injection molded zirconia-toughened alumina: Towards osseointegrated and antibacterial ceramic implants

“…Based on the in vitro release experiments, loading with gentamicin-encapsulated liposomes was selected as the best method to test antibacterial properties against E. coli, which is the most frequently isolated microorganism from gram-negative periprosthetic joint infections [52][53][54].…”

Late Prosthetic Joint Infection and Bacteremia by Bacillus cereus Confirmed by 16S rRNA Sequencing and Hip Joint Tissue Pathology

“…Staphylococcus aureus and coagulase negative staphylococci have been known as common etiologic agents of prosthetic joint infection [12] but Bacillus spp. is not.…”