Difficult-to-treat pathogens significantly reduce infection resolution in periprosthetic joint infections

Periprosthetic joint infection (PJI) is a feared complication after arthroplasty. Our hypothesis was that PJI caused by difficult-to-treat (DTT) pathogens has a worse outcome compared with non-DTT PJI. Routine clinical data on 77 consecutive patients with confirmed PJI treated with 2-stage exchange...

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Published in:Diagnostic microbiology and infectious disease 2020-10, Vol.98 (2), p.115114-115114, Article 115114
Main Authors: Wimmer, Matthias D., Hischebeth, Gunnar T.R., Randau, Thomas M., Gathen, Martin, Schildberg, Frank A., Fröschen, Frank S., Kohlhof, Hendrik, Gravius, Sascha
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Arthroplasty
Arthroplasty, Replacement - adverse effects
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Knee - adverse effects
Bacteria - drug effects
Difficult-to-treat
DTT
Female
Follow-Up Studies
Humans
Infection
Joint Prosthesis - adverse effects
Male
Middle Aged
Periprosthetic joint infection
Prosthesis-Related Infections - drug therapy
Prosthesis-Related Infections - microbiology
Prosthesis-Related Infections - surgery
Reoperation - adverse effects
Retrospective Studies
Revision
Risk Factors
Treatment Outcome
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Summary:Periprosthetic joint infection (PJI) is a feared complication after arthroplasty. Our hypothesis was that PJI caused by difficult-to-treat (DTT) pathogens has a worse outcome compared with non-DTT PJI. Routine clinical data on 77 consecutive patients with confirmed PJI treated with 2-stage exchange arthroplasty were placed in DTT and non-DTT PJI groups and analyzed. The main outcome variable was that the patient was definitively free of infection after 2 years. We found definitive infection resolution in 31 patients in the DTT group (68.9%) and 28 patients (87.5%) in the non-DTT group (P < 0.05). The necessity for revision surgery until assumed resolution of infection was significantly more frequent in the DTT group with 4.72 ± 3.03 operations versus 2.41 ± 3.02 operations in the non-DTT group (P < 0.05). PJI caused by DTT bacteria is associated with significantly higher numbers of revision operations and significantly inferior definitive infection resolution.
ISSN:0732-8893
1879-0070
DOI:10.1016/j.diagmicrobio.2020.115114