Treatment of Prosthetic Joint Infection due to Listeria Monocytogenes. A Comprehensive Literature Review and a Case of Total Hip Arthroplasty Infection

Abstract

As reported in contemporary literature, prosthetic joint infection (PJI) caused by Listeria monocytogenes (LM) is a rare infection affecting mainly immunocompromised patients. It is considered a late complication occurring months or years after the arthroplasty that is treated with, or without, implant retention, in one-stage or two-stage surgical procedures, and long-term administration of antibiotics. We reviewed the published studies in the English language and present a case of a patient who underwent total hip arthroplasty (THA) and had been affected by this infection. Our patient was successfully treated with 3 months of antibiotics (ampicillin and TMP/SMX) and a two-stage surgical procedure. The success rates of conservative treatment and one-stage or two-stage procedures are dependent on appropriate patient selection and chronicity of the infection. Ιmmmunocompromised patients are susceptible to PJI caused by LM and should be advised that consumption of unpasteurized dairy products increases the risk of this atypical infection.

Case report: Occult Listeria monocytogenes invasion leading to prosthetic hip joint infection in a patient with rheumatoid arthritis taking tofacitinib

“…In another literature review of case reports, prosthetic joint infections due to L. monocytogenes mainly affected the hip (70%, 48/68) and knee (30%, 20/68) joints, and about 31% of the patients were on immunosuppressants. L. monocytogenes infections in prosthetic joints can manifest months to years after surgery, with an average onset time of 6.8 years, ranging from 2 months to 21 years ( 12 ). Among them, there were 7 and 10 patients with rheumatoid arthritis in the two articles, respectively.…”

“…Although there are no guidelines or expert consensus on the diagnosis and treatment of L. monocytogenes joint implant infections, we believe that scientific and standardized strategies are needed for the management of such diseases. Research has proposed that the antibiotic treatment regimen for L. monocytogenes purulent arthritis ranges from parenteral administration for 2 weeks to oral administration for 6 months, combined with surgical treatment such as debridement, removal of implants, or joint fusion ( 12 ). Because L. monocytogenes is intrinsically resistant to all generation of cephalosporin, antibiotic selection is particularly important.…”