Microbiological pathogen analysis in native versus periprosthetic joint infections: a retrospective study

Abstract

Background The presence or absence of an implant has a major impact on the type of joint infection therapy. Thus, the aim of this study was the examination of potential differences in the spectrum of pathogens in patients with periprosthetic joint infections (PJI) as compared to patients with native joint infections (NJI). Methods In this retrospective study, we evaluated culture-positive synovial fluid samples of 192 consecutive patients obtained from January 2018 to January 2020 in a tertiary care university hospital. For metrically distributed parameters, Mann–Whitney U was used for comparison between groups. In case of nominal data, crosstabs and Chi-squared tests were implemented. Results Overall, 132 patients suffered from periprosthetic joint infections and 60 patients had infections of native joints. The most commonly isolated bacteria were coagulase-negative Staphylococci (CNS, 28%), followed by Staphylococcus aureus (S. aureus, 26.7%), and other bacteria, such as Streptococci (26.3%). We observed a significant dependence between the types of bacteria and the presence of a joint replacement (p < 0.05). Accordingly, detections of CNS occurred 2.5-fold more frequently in prosthetic as compared to native joint infections (33.9% vs. 13.4% p < 0.05). In contrast, S. aureus was observed 3.2-fold more often in NJIs as compared to PJIs (52.2% vs. 16.4%, p < 0.05). Conclusion The pathogen spectra of periprosthetic and native joint infections differ considerably. However, CNS and S. aureus are the predominant microorganisms in both, PJIs and NJIs, which may guide antimicrobial therapy until microbiologic specification of the causative pathogen.

Microbial spectrum, patient-specific factors, and diagnostics in implant-related postoperative spondylodiscitis

“…29 The spectrum of pathogens found in this study was similar to that of periprosthetic joint infections (PJIs) of the knee and hip, with gram-positive cocci accounting for the majority of positive samples. [30][31][32] However, in contrast to primary spondylodiscitis, in which S. aureus has been shown to be the most common causative pathogen, in our case series S. epidermidis predominated which is in line with the literature on native peripheral joint infection versus PJI. 30,[33][34][35] Furthermore, an aspect to be taken into account is recent reports on the intervertebral disc's microbiome, which may be a cause for subclinical infections as an underlying mechanism of degeneration and may predispose patients to IPOS even prior to the index surgery.…”

“…[30][31][32] However, in contrast to primary spondylodiscitis, in which S. aureus has been shown to be the most common causative pathogen, in our case series S. epidermidis predominated which is in line with the literature on native peripheral joint infection versus PJI. 30,[33][34][35] Furthermore, an aspect to be taken into account is recent reports on the intervertebral disc's microbiome, which may be a cause for subclinical infections as an underlying mechanism of degeneration and may predispose patients to IPOS even prior to the index surgery. 36 Sonication delivered positive results in four out of five cases (80.0%).…”

Prosthetic Joint Infections: Biofilm Formation, Management, and the Potential of Mesoporous Bioactive Glass as a New Treatment Option

“…In a retrospective study conducted by Linke et al (2022), they evaluated culture-positive synovial samples of different patients. Their results led to the conclusion that the most detected species causing prosthetic joint infections are Staphylococcal species causing around 50% of the infections, and coagulase-negative staphylococci causing around 33% of the PJIs [ 13 ]. This is in line with other studies that looked at the pathogens causing these infections.…”

Use of non-thermal plasma for decontamination of titanium implants

“…The incidence of SSI can be as high as 20%, depending on the surgical procedure, the followup criteria used, and the quality of the data collection [2], [3]. The most frequently SSI-associated microorganisms are Staphylococcus aureus, coagulase-negative staphylococci, Pseudomonas aeruginosa, Escherichia coli and some others [4], [5]. The risk of SSI is influenced by numerous patientand procedure-related factors, and therefore prevention requires a comprehensive approach with systematic attention to multiple risk factors to reduce the possibility of bacterial contamination.…”