Microbiology of hip and knee periprosthetic joint infections: a database study

Tai, Don Bambino Geno; Patel, Robin; Abdel, Matthew P.; Berbari, Elie F.; Tande, Aaron J.

doi:10.1016/j.cmi.2021.06.006

Cited by 53 publications

(36 citation statements)

References 29 publications

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“…We found a very low prevalence of monomicrobial Corynebacterium PJI at our institution, consistent with previous literature [ 7 ]. Previous studies from other centers from the United States, Russia, Argentina, Uruguay, and Germany also reported a low prevalence of Corynebacterium in hip and knee PJI (≤2.5% detection rate) [ 13 , 14 ].…”

Section: Discussionsupporting

confidence: 92%

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Clinical Profile of Monomicrobial Corynebacterium Hip and Knee Periprosthetic Joint Infections

Tabaja

Tai

Beam

et al. 2022

Open Forum Infectious Diseases

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Background Corynebacterium periprosthetic joint infection (PJI) is a poorly described infectious syndrome. Prior studies included cases of polymicrobial infections. This series describes the clinical characteristics, management, and outcomes of monomicrobial Corynebacterium PJI. Methods We queried the Mayo Clinic Total Joint Registry for cases of monomicrobial Corynebacterium knee and hip PJI in adults ≥18 years old between 2010-2019. Results A total of 20 (1%) out of 2,067 PJI cases met our inclusion criteria. Most were males (55%), and the median age was 64 years. Seventy percent had chronic symptoms (>4 weeks). PJI was delayed-to-late (>3 months post-implantation) in 90%. Three species were identified: C. striatum (70%), C. jeikeium (20%), and C. amycolatum (10%). All tested isolates were susceptible to vancomycin (100%) and linezolid (100%), and most had MIC ≤0.06 mcg/mL to daptomycin (75%). Other agents were less reliable with high resistance to oral agents commonly used for suppression. Nineteen patients were treated: 37% debridement and implant retention (DAIR), 47% 2-stage exchange, and 16% resection without reimplantation. Of these, failure occurred in 29%, 11%, and 0%, respectively. Conclusion Corynebacterium PJIs pose a therapeutic challenge due to limited antimicrobial armamentarium and undefined optimal surgical intervention. Vancomycin and linezolid remain the most reliable agents for treatment. DAIR may be attempted for acute PJI, but verification of durable chronic suppression options will be critical for this approach.

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Section: Discussionsupporting

confidence: 92%

“…Corynebacterium spp. may be isolated in up to 5% of cases of periprosthetic joint infections (PJIs) and the only organism isolated in 2% [ 7 ].…”

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confidence: 99%

Clinical Profile of Monomicrobial Corynebacterium Hip and Knee Periprosthetic Joint Infections

Tabaja

Tai

Beam

et al. 2022

Open Forum Infectious Diseases

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“…This study has some limitations. First, the efficacy of high-dose rifampin was tested against a single community-acquired MRSA (CA-MRSA) strain, and it is not yet known whether these results could be expanded to other staphylococcal strains as well as to other staphylococcal species, particularly coagulase-negative staphylococci, which are often involved in orthopedic implant-associated infections (66). Second, rifampin combination treatment with either vancomycin or linezolid was evaluated; however, other antibiotic combinations are commonly used.…”

Section: Discussionmentioning

confidence: 99%

Dynamic PET-facilitated modeling and high-dose rifampin regimens for Staphylococcus aureus orthopedic implant–associated infections

et al. 2021

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“…For the best results, this interdisciplinary approach is essential. Regarding the pathophysiology, diagnosis, classification, and therapeutic strategy for PJI, we offer a perspective on current management methods in this review article [4][5][6] . Arthroplasties on the hip and knee are effective elective surgical procedures, with a 10-year survival rate of more than 95%.…”

Section: Introductionmentioning

confidence: 99%

Infection of the periprosthetic joint: Current views and forecasts

Rao¹,

Reddy²,

Reddy³

2022

Int. J. Orthop. Sci.

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Infections of the periprosthetic joint are catastrophic complications that can arise following arthroplasty. They are also associated with a significant increase in patient morbidity. More than twenty-five percent of all changes can be traced back to these illnesses, and it is anticipated that this number will continue to rise. This rise can be attributed, in part, to the rising rates of obesity and diabetes, as well as to an increased incidence of other comorbidities. Recognition of the difficulty of surgical site infections in general, and periprosthetic joint infections, has prompted implementation of enhanced prevention measures preoperatively, intra operatively (Ultraclean operative environment, blood conservation, etc.), and postoperatively. These enhanced prevention measures can be divided into three categories: preoperative, intraoperative, and postoperative (Refined anticoagulation and improved wound dressings). Indications for surgical management have also been refined, which is another positive development. In this Review, we investigate the risk factors, preventative measures, diagnostic procedures, clinical characteristics, and treatment choices associated with prosthetic joint infection. The most effective treatments and areas in which more investigation is required were determined during a meeting of experts worldwide to discuss these infections. Improvements in preventive, diagnostic, and treatment procedures could benefit the field of orthopedics.

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Microbiology of hip and knee periprosthetic joint infections: a database study

Cited by 53 publications

References 29 publications

Clinical Profile of Monomicrobial Corynebacterium Hip and Knee Periprosthetic Joint Infections

Clinical Profile of Monomicrobial Corynebacterium Hip and Knee Periprosthetic Joint Infections

Dynamic PET-facilitated modeling and high-dose rifampin regimens for Staphylococcus aureus orthopedic implant–associated infections

Infection of the periprosthetic joint: Current views and forecasts

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