Prosthetic Joint Infections Due to Coagulase-Negative Staphylococci

Abstract

Context: Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are the most frequently isolated pathogens and are responsible for approximately two-thirds of joint replacement infections. Evidence Acquisition: Although both belong to the staphylococci genus, there are several epidemiological and therapeutic differences between S. aureus and the heterogenous group of CoNS. In general, however, preventive and therapeutic recommendations for Prosthetic Joint Infection PJI due to CoNS do not differ from PJI caused by other pathogens. Results: The main differences between the pathogens lie in the clinical presentation of PJI, the presumed origin of infection, and the presence of a higher proportion of methicillin-resistant strains leading to a limited choice of antibiotic agents. Conclusions: Fortunately, due to its lower virulence as compared to its cousin S. aureus, PJI due to CoNS may display higher remission rates than S. aureus-caused PJI after combined surgical and medical management.

Staphylococcus spp. resistentes em hemoculturas e superfícies hospitalares e a segurança do paciente

“…15,17 Contamination lying around the ICU patients was observed in the present study in 95% of the collected samples. For positive Gram, we observed a higher prevalence of bacteria from the group of coagulase-negative Staphylococci -CoNS (76.92%) in relation to the species Staphylococcus aureus (23.07%).…”

“…According to the results from the susceptibility test antimicrobial, 87.5% of the samples identified as CoNS showed resistance to oxacilin, corroborating with previous studies that have estimated that the CoNS isolated in hospitals in Brazil, 70% to 90%, usually have shown resistance to oxacillin. [17][18][19] During the last decades, the substantial increase in CoNS isolated in hospital settings, as well as their oxacillin resistance rates has increased significantly its clinical importance, becoming recognized as opportunistic agents often associated with nosocomial infections. 17,19 As a result, it reinforces the importance of performing increasingly accurate cultures, especially as regards the antibiogram that will contribute to conduct towards the use of more rational way, in a more targeted therapy, particularly in hospital environment.…”

“…The identification of microorganisms in hospital surfaces has been important in epidemiological investigations and suggest the environment as a possible source of transmission of nosocomial infections. 15,17 One of the greatest ways to spread of hospital infections occur through cross-infection, which is caused by the transmission of microorganisms between patients or through the hands of professionals, caregivers and visitors, and health professionals the main contributors to this spread. The acquisition of microorganisms may also occur through direct contact with the patient material or contaminated environment.…”

The Epidemiology and Outcomes of Septic Arthritis in the Maltese Islands: A Hospital-Based Retrospective Cohort Study

“…Similar infection rates for all organisms cultured was observed when native joint infections were compared to PJIs, apart from the much higher rates of clinically significant prosthetic infections with CoNS (23.1% vs 4.5% for PJIs and native joint infections respectively, p= <0.001) – this is also in-keeping with other studies carried out in Europe and the US which showed that CoNS together with Staphylococcus aureus are the most common isolated organisms in PJIs, accounting for up to two-thirds of cases. 25 , 26 Higher rates of infection with gram negative organisms was also noted in prosthetic joints (23.1%) compared to native joints (15.9%), but this was not shown to be statistically significant (p= 0.224). It is also interesting to note that no cases of gonococcal arthritis were encountered in this study.…”

Incidence and Risk Factors of 30-Day Surgical Site Infection after Primary Total Joint Arthroplasty in a Middle-Income Country: A Single-Center Experience

“…Coagulase-negative staphylococci, with Staphylococcus epidermidis as the most prevalent among all CoNS, are part of the normal microbial flora of human skin. Although these microorganisms are often considered contaminants, deep implant infections caused by those pathogens can lead to severe complications, sometimes even to implant removal [31]. In our study, two deep hip and knee surgical site infections were caused by resistant CoNS.…”