Increased risk of joint failure in hip prostheses infected with Staphylococcus aureus treated with debridement, antibiotics and implant retention compared to Streptococcus

Betz, Michael; Abrassart, Sophie; Vaudaux, Pierre; Gjika, Ergys; Schindler, Maximilian; Billières, Julien; Zenelaj, Besa; Suvà, Domizio; Peter, Robin; Uçkay, İlker

doi:10.1007/s00264-014-2510-z

Cited by 42 publications

(40 citation statements)

References 25 publications

(37 reference statements)

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“…Accordingly, the authors suggested that the decision for I&D with retention of the knee prosthesis should be dependent in the first instance on the nature of the infecting pathogen. Betz et al [60] reported similar results in infected hip arthroplasties, with an average 21% failure rate of Staphylococcus aureus infections compared to no failure of streptococcal infections treated with DAIR. Interestingly, Lora-Tamayo et al [31] reported that the treatment of MRSA PJIs was not less successful than methicillin-susceptible Staphylococcus aureus (MSSA) infections if rifampin-based antibiotic combinations were administered during the first 30 days after debridement to both groups.…”

Section: Prognostic Factors For Infection Controlmentioning

confidence: 87%

“…One of the most recognized factors associated with high failures is infection due to methicillin-resistant Staphylococcus aureus (MRSA) [69]. The poor prognosis and high risk of re-infection due to MRSA is linked to the limited availability of selective antibiotics and the potential insurgence of glycopeptide resistance in vancomycin-treated patients [60, 70]. Zürcher-Pfund et al [71] treated 21 infected TKRs with a combination of debridement and antibiotics and followed them up for a mean of 7 years.…”

Section: Prognostic Factors For Infection Controlmentioning

confidence: 99%

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Aggressive Early Debridement in Treatment of Acute Periprosthetic Joint Infections After Hip and Knee Replacements

Volpin¹,

Sukeik²,

Alazzawi³

et al. 2016

TOORTHJ

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Background:Periprosthetic Joint Infection Remains a Dreaded Complication After Hip and Knee Replacement Surgery.Treatment Options for Acute Postoperative and Acute Hematogenous Infections Include Arthroscopic or Open Debridement With Retention or Exchange of the Prostheses. This Review Article Aims to Summarize the Evidence for Management of Acute Postoperative And Acute Hematogenous Infections.Methods:A Systematic Literature Search Was Performed Using a Computer-based Search Engine Covering Medline (OvidSP), PubMed Database (U.S. National Library of Medicine, National Institutes of Health), Embase, Web of Science, Cochrane and Google Scholar for Relevant Articles.Results:Common Themes Around Treatment of Acute Postoperative and Acute Hematogenous Infections Discussed in this Review Include the Timing of Intervention, Description of the Optimal Procedure and How we Perform it at our Institution, the Role of Arthroscopic Debridement, Most Commonly Isolated Micro-organisms and Prognostic Factors for Infection Control.Conclusion:Success in Treating Acute Postoperative and Acute Hematogenous Infections Depends on Early Diagnosis and Aggressive Surgical Debridement Combined With Effective Antibiotic Therapy.

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Section: Prognostic Factors For Infection Controlmentioning

confidence: 87%

Section: Prognostic Factors For Infection Controlmentioning

confidence: 99%

Aggressive Early Debridement in Treatment of Acute Periprosthetic Joint Infections After Hip and Knee Replacements

Volpin¹,

Sukeik²,

Alazzawi³

et al. 2016

TOORTHJ

View full text Add to dashboard Cite

show abstract

“…Lora-Tamayo et al [24] In earlier studies, the factors associated with poor outcomes in DAIR-treated PJIs included S. aureus infection [8,10,11,26,27], coagulase-negative Staphylococcus infection [9,11], and polymicrobial infection [12]. S. aureus PJIs have been shown to have worse outcomes than PJIs caused by Streptococcus species [27,28]. Infections by methicillinresistant S. aureus (MRSA) have been suggested to have a worse prognosis than infections by methicillin-susceptible S. aureus (MSSA), but this finding is controversial [12].…”

Section: Discussionmentioning

confidence: 97%

Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention

Puhto

Niinimäki

et al. 2015

International Orthopaedics (SICOT)

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“…Debridement, antibiotic and implant retention has excellent results for non-resistant Streptococcal PJI, with 100% success in one series of 14 cases [124]. However, prosthesis retention has been significantly associated with treatment failure of Enterococcal PJIs, particularly if they present greater than 2 years after the index arthroplasty [37].…”

Section: Managementmentioning

confidence: 99%

Management of Resistant, Atypical and Culture-negative Periprosthetic Joint Infections after Hip and Knee Arthroplasty

McLawhorn¹,

Nawabi²,

Ranawat³

2016

TOORTHJ

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Background:Periprosthetic joint infection (PJI) is a devastating complication following lower extremity total joint arthroplasty (TJA). It is a leading cause of morbidity and revision following TJA. As such, PJI is a significant driver of healthcare costs. The prevalence of PJI related to resistant and atypical organisms is increasing, and approximately 10-30% of PJIs are culture-negative. The purpose of this review is to summarize the current epidemiology, diagnostics, and management of PJI associated with resistant and atypical pathogens and of culture-negative PJIs.Methods:The published literature related to the epidemiology, diagnosis, and management of atypical, drug-resistant, and culture-negative PJI is reviewed.Results:The clinical diagnosis of PJI is often challenging, particularly when pathogens are fastidious or when antibiotics have been administered empirically. Molecular diagnostic studies, such as synovial α-defensin, may provide rapid, accurate identification of PJI, even in the setting of concurrent antibiotics administration or systemic inflammatory disease. Once PJI is diagnosed, two-stage exchange arthroplasty remains the gold standard for treating PJI with resistant microorganisms, since there is a high rate of treatment failure with irrigation and debridement and with one-stage exchange arthroplasty.Conclusion:Additional research is needed to define the optimal treatment of PJIs associated with rare pathogens, such as fungi and mycobacteria. There is a need for inexpensive, reliable tests that rapidly detect specific microbial species and antimicrobial susceptibilities. Additional research is also required to define the specific organisms, clinical scenarios, surgical techniques, and antimicrobial regimens that allow for reproducible treatment success with prosthetic retention strategies.

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Increased risk of joint failure in hip prostheses infected with Staphylococcus aureus treated with debridement, antibiotics and implant retention compared to Streptococcus

Abstract: DAIR-treated patients with prosthetic hip joint infections due to S. aureus tended to have worse outcomes than those infected with Streptococcus spp. The specific influence of the infecting pathogen should be considered in future guidelines and recommendations.

Cited by 42 publications

References 25 publications

Aggressive Early Debridement in Treatment of Acute Periprosthetic Joint Infections After Hip and Knee Replacements

Aggressive Early Debridement in Treatment of Acute Periprosthetic Joint Infections After Hip and Knee Replacements

Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention

Management of Resistant, Atypical and Culture-negative Periprosthetic Joint Infections after Hip and Knee Arthroplasty

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