Eight years experience in treatment of prosthetic joint infections at a teaching hospital in Central Taiwan

Tseng, Shu-Wen; Chi, Chih-Yu; Wang, Yi-Jen; Liao, Chia-Hung; Ho, Cheng-Mao; Lin, Pin Wen; Ho, Mao‐Wang; Wang, Jen-Hsian

doi:10.1016/j.jmii.2011.12.014

Cited by 16 publications

(9 citation statements)

References 31 publications

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“…Leading among the symptoms were joint pain and an unspecific feeling of illness. Our results showed that joint pain occurred in 85% of patients, which is consistent with other studies that showed its occurrence in almost 80% -100% of cases [16] [17] [18].…”

Section: Discussionsupporting

confidence: 93%

“…Successful disease management could be reflected in some clinical and laboratory parameters, as our results show. Where more than half of our patients had fever at the time of admission, this was only a few percent of patients with this clinical symptom, in contrast to other studies [16] [17]. Although this symptom may not have been present in all patients and may not have been the most common in our study, if present, it could be a very specific finding for the diagnosis of PJI with sepsis [44].…”

Section: Discussioncontrasting

confidence: 72%

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PJI with Sepsis, a Complex Emergency Situation with Prodromal Stage

Haustedt¹,

Chapa²,

Hentschke³

2020

OJO

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Introduction: With a considerable morbidity, mortality and a high financial impact, PJI has been considered as one of the most serious complications after arthroplasty. Special awareness must be given to these patients due to a life threatening systemic PJI related complication, sepsis. A prompt detection and adequate medical management of this situation is crucial for avoiding unfavorable outcomes. Methods: Between January 2011 and December 2012, we retrospectively examined adult patients who met PJI-SIRS criteria. Medical history search for patients' anamnesis, surgical times, laboratory-microbiological findings and success rates was performed. Results: Twenty patients were enrolled in this study with a mean age of 71.35 years. Men population was more commonly affected with 55% of the cases. The knee was mainly the affected joint with 52%. A severe systemic disease was present in 80% of the cases. A sickness sensation and pain were the most common prodromal symptoms found 4.9 days before the admission to the hospital. In 85.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 72%

PJI with Sepsis, a Complex Emergency Situation with Prodromal Stage

Haustedt¹,

Chapa²,

Hentschke³

2020

OJO

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“…When compared to 19 previously reported Gram-negative PJIs with non-resistant strains, 24 it is clear that CRKP-related infections are more severe. Specifically, the median duration of hospital stay was longer (101 days vs. 31 days), median WBC was higher (14.92 × 10 9 /l vs. 8.1 × 10 9 /l), and mortality was higher (67% vs. 5%) for patients with CRKP PJIs.…”

Section: Discussionmentioning

confidence: 71%

Complex prosthetic joint infections due to carbapenemase-producing Klebsiella pneumoniae: a unique challenge in the era of untreatable infections

Sanctis

Teixeira

Duin

et al. 2014

International Journal of Infectious Diseases

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SUMMARY Objectives Limited clinical experience exists regarding the management of prosthetic joint infection (PJI) due to multidrug-resistant (MDR) Gram-negative organisms. We review three cases of carbapenem-resistant Klebsiella pneumoniae (CRKP) complicating PJI. Methods This was a retrospective study of all patients at a tertiary care institution with CRKP complicating PJI between January 2007 and December 2010. Demographic data, procedures, organisms involved, length of stay, antibiotic treatments, and outcomes were collected. Antimicrobial susceptibility testing was performed on CRKP isolates, and the mechanism of resistance was ascertained by PCR. Results This analysis demonstrated that: (1) the CRKP possessed blaKPC and were difficult to eradicate (persistent) in PJI; (2) multiple surgeries and antibiotic courses were undertaken and patients required a prolonged length of stay; (3) resistance to colistin and amikacin emerged on therapy; (4) the same strain of CRKP may be responsible for relapse of infection; (5) significant morbidity and mortality resulted. Conclusions These cases highlight the opportunistic and chronic nature of CRKP in PJIs and the need for aggressive medical and surgical treatment. Further investigations of the management of CRKP PJI and new drug therapies for infections due to MDR Gram-negative organisms are urgently needed.

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“…In general, pain seems to be the most frequently reported clinical manifestation, with case series reporting between 79 and 100% of patients with this finding (7,58,(63)(64)(65)(66). However, a study by Peel and colleagues found that pain was present in only 42% of patients, while drainage from the surgical wound was the most frequent finding in 72% of patients (57).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Prosthetic Joint Infection

2014

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SUMMARY Prosthetic joint infection (PJI) is a tremendous burden for individual patients as well as the global health care industry. While a small minority of joint arthroplasties will become infected, appropriate recognition and management are critical to preserve or restore adequate function and prevent excess morbidity. In this review, we describe the reported risk factors for and clinical manifestations of PJI. We discuss the pathogenesis of PJI and the numerous microorganisms that can cause this devastating infection. The recently proposed consensus definitions of PJI and approaches to accurate diagnosis are reviewed in detail. An overview of the treatment and prevention of this challenging condition is provided.

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Eight years experience in treatment of prosthetic joint infections at a teaching hospital in Central Taiwan

Abstract: GN PJI was less common than GP PJI, but GN PJI was more complicated and required longer treatment. Prospective randomized clinical studies are needed to investigate whether prosthesis implantation should be reserved if the patient undergoes early surgical intervention for PJI.

Cited by 16 publications

References 31 publications

PJI with Sepsis, a Complex Emergency Situation with Prodromal Stage

PJI with Sepsis, a Complex Emergency Situation with Prodromal Stage

Complex prosthetic joint infections due to carbapenemase-producing Klebsiella pneumoniae: a unique challenge in the era of untreatable infections

Prosthetic Joint Infection

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