Polymicrobial Colonization of Prosthetic Joint Infections Treated With Open Wound Management

Valenzuela, Michael M.; Averkamp, Benjamin J.; Odum, Susan M.; Rowe, Taylor; Fehring, Thomas K.

doi:10.1016/j.arth.2022.03.016

Cited by 3 publications

(2 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Polymicrobial infections have been considered an independent risk factor for infection recurrence following several surgical treatments for PJI [ 16 , 52 , 53 ]. Razii et al reported that polymicrobial infections were associated with increased reinfection [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Characterizing recurrent infections after one-stage revision for periprosthetic joint infection of the knee: a systematic review of the literature

Bosco

Cacciola

Giustra

et al. 2023

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Background Periprosthetic joint infection (PJI) of the knee represents a severe complication after 1.5% to 2% of primary total knee replacement. Although two-stage revision was considered the gold-standard treatment for PJI of the knee, in the last decades, more studies reported the outcomes of one-stage revisions. This systematic review aims to assess reinfection rate, infection-free survival after reoperation for recurrent infection, and the microorganisms involved in both primary and recurrent infection. Material and methods A systematic review of all studies reporting the outcome of one-stage revision for PJI of the knee up to September 2022, according to PRISMA criteria and AMSTAR2 guidelines, was performed. Patient demographics, clinical, surgical, and postoperative data were recorded. PROSPERO ID: CRD42022362767. Results Eighteen studies with a total of 881 one-stage revisions for PJI of the knee were analyzed. A reinfection rate of 12.2% after an average follow-up of 57.6 months was reported. The most frequent causative microorganism were gram-positive bacteria (71.1%), gram-negative bacteria (7.1%), and polymicrobial infections (8%). The average postoperative knee society score was 81.5, and the average postoperative knee function score was 74.2. The infection-free survival after treatment for recurrent infection was 92.1%. The causative microorganisms at reinfections differed significantly from the primary infection (gram-positive 44.4%, gram-negative 11.1%). Conclusion Patients who underwent a one-stage revision for PJI of the knee showed a reinfection rate lower or comparable to other surgical treatments as two-stage or DAIR (debridement, antibiotics, and implant retention). Reoperation for reinfection demonstrates a lower success compared to one-stage revision. Moreover, microbiology differs between primary infection and recurrent infection. Level of evidence Level IV.

show abstract

Section: Discussionmentioning

confidence: 99%

Characterizing recurrent infections after one-stage revision for periprosthetic joint infection of the knee: a systematic review of the literature

Bosco

Cacciola

Giustra

et al. 2023

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

show abstract

“…Fistulae or sinus tracts are common in PJIs and can be treated with simple excision during a two- or even a one-stage procedure [ 13 ]. On the other side, severe soft tissue defects are normally harder to treat, may lead to the polymicrobial colonization of the indwelling prosthesis, and frequently require free flap surgery with an overall worse outcome compared to standard wound closure procedures [ 14 , 15 , 16 ] and, in our eyes, should not be put into the same category as fistulae.…”

Section: Commentmentioning

confidence: 99%

Comment on Lunz et al. Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections. J. Clin. Med. 2023, 12, 1262

Alt,

Walter,

Rupp

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

Twelve-Year Dynamics of Leading Pathogens Spectrum Causing Orthopedic Infection: A Retrospective Study

Kasimova,

Tufanova,

Gordina

et al. 2024

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

Introduction. The number of surgical interventions on the musculoskeletal system increases every year. Simultaneously with the increasing availability of orthopedic care, the number of patients with orthopedic infection is increasing. Etiological agents in the development of orthopedic infection can be representatives of various taxonomic groups. Staphylococcus aureus and various types of coagulase-negative staphylococci (СоNS), including S. epidermidis and S. lugdunensis, together are pathogens in 70% of cases Aim of the study. To analyze the dynamics of the spectrum of leading pathogens isolated from patients of the department of purulent osteology for the period from 2011 to 2022. Materials and methods. A retrospective analysis of the spectrum of microorganisms isolated from patients treated in the department of purulent surgery from January 1, 2011 to December 31, 2022 was performed. The leading pathogens included microorganisms whose share in the spectrum exceeded 3.5%. Of the isolated pathogens, 48.8% were the only etiological agents, 51.2% determined the presence of microbial associations. Results. Over a 12-year period, 10,327 strains of various bacterial species were identified. The leading microorganisms isolated from patients with orthopedic infection were Staphylococcus spp., Enterococcus spp., Propionibacterium spp., Pseudomonas aeruginosa, Corynebacterium spp., Streptococcus spp., Klebsiella spp. and Acinetobacter spp. Several trends were revealed in the dynamics of isolated pathogens during the analyzed period: a decrease in the proportion of S. aureus, Enterococcus spp., P. aeruginosa, Acinetobacter spp. and an increase in CoNS and Corynebacterium spp. Conclusion. The study showed that for 12 years gram-positive bacteria, mainly belonging to the genus Staphylococcus, were included in the spectrum of the main pathogens of orthopedic infection in patients with purulent surgery of our center. At the same time, there was a significant decrease in the proportion of S. aureus strains and an increase in the frequency of isolation of various types of cons. There was also a significant decrease in the number of non-fermenting gram-negative bacteria

show abstract

Polymicrobial Colonization of Prosthetic Joint Infections Treated With Open Wound Management

Cited by 3 publications

References 32 publications

Characterizing recurrent infections after one-stage revision for periprosthetic joint infection of the knee: a systematic review of the literature

Characterizing recurrent infections after one-stage revision for periprosthetic joint infection of the knee: a systematic review of the literature

Comment on Lunz et al. Impact and Modification of the New PJI-TNM Classification for Periprosthetic Joint Infections. J. Clin. Med. 2023, 12, 1262

Twelve-Year Dynamics of Leading Pathogens Spectrum Causing Orthopedic Infection: A Retrospective Study

Contact Info

Product

Resources

About