Infections after shoulder arthroplasty are correlated with higher anesthetic risk score: a case-control study in Brazil

Nagaya, Leonardo Hideto; Salles, Mauro José Costa; Takikawa, L.; Fregoneze, Marcelo; Doneux, Pedro; Silva, Luciana Andrade da; Sella, Guilherme do Val; Miyazaki, Alberto Naoki; Checchia, Sérgio Luiz

doi:10.1016/j.bjid.2017.06.003

Cited by 14 publications

(27 citation statements)

References 25 publications

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“…,Gao et al (2010),Gil-Londoño et al (2016),Giri et al (2008),Hafez et al (2012),Hao et al (2013),Hernaiz-Leonardo et al (2017),Hey et al (2017),Ibrahim et al (2014),Jyothirmayi et al (2017),Kanafani et al (2006),Khan et al (2010),Khan et al (2011),Ledur et al (2011),Lee et al (2007),Lee et al (2010),Lee et al (2015),Legesse Laloto et al (2017),Leon et al (2011),Li et al (2013),Liu et al (2017),Lyimo et al (2013),Madu et al (2011), El Maerrawi and Carvalho (2015),Malik et al (2009),Martins et al (2008),Marwa et al (2015),Mathur et al (2013),Mawalla et al (2011),Mehrabi Bahar et al (2015),Memon et al (2013),Mundhada and Tenpe (2015),Nagaya et al (2017),Ng et al (2015),Ning et al (2014),Nwankwo and Edino (2014),Oliveira and Carvalho (2004),Pardhan et al (2013), Porras-Hernandez et al (2008,Portillo-Gallo et al (2014),Qi et al (2013),Qin et al (2014),Qiu et al (2011),Rabiu ...…”

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confidence: 99%

Surgical site infection in elective clean and clean-contaminated surgeries in developing countries

Curcio

Cané

Fernández³

et al. 2019

International Journal of Infectious Diseases

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Background: Surgical site infection (SSI) is both the most frequently studied healthcare-associated infection and the most common healthcare-associated infection in the developing world. A systematic review and meta-analysis was conducted to evaluate the relative size of this burden and to estimate the prevalence of SSI in clean and clean-contaminated surgeries in a large sample of countries in the developing world. Methods: A systematic search of the MEDLINE/PubMed, Scopus, and LILACS databases was conducted to identify studies providing the prevalence of SSI in elective clean and clean-contaminated surgeries in 39 countries or regions around the world. Data of interest were limited to publications from January 2000 to December 2017. Studies with information on the number of cases of SSI and number of total elective clean and clean-contaminated surgeries during the same period were included in this evaluation. Studies lacking clear definition of the total number of exposed patients were excluded. Results: Based on the combined data from the 99 articles evaluated in this analysis, the overall prevalence of SSI in elective clean and clean-contaminated surgeries was estimated to be 6% (95% confidence interval (CI) 5-7%). This increased to 15% (95% CI 6-27%) when considering only those reports with post-discharge surveillance data. The overall prevalence of SSI in Africa/Middle East, Latin America, Asia, and China was 10% (95% CI 6-15%), 7% (95% CI 5-10%), 4% (95% CI 4-5%), and 4% (95% CI 2-6%), respectively. Significant variability in the data was confirmed by both the funnel plot and the Egger test (p = 0.008). Conclusions: Although the data are variable, it is clear that the incidence of SSI in the developing world is higher than that in the developed world.

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mentioning

confidence: 99%

Surgical site infection in elective clean and clean-contaminated surgeries in developing countries

Curcio

Cané

Fernández³

et al. 2019

International Journal of Infectious Diseases

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“…The formation of hematoma or postoperative drainage for more than 2.5 days following arthroplasty has been identified previously as a predictor of wound infection for patients receiving hip and knee joint replacements [30]. In shoulder arthroplasty, an association between postoperative hematoma and subsequent PJI was documented by Cheung et al [31] and Nagaya et al [6]. Cheung et al [31] identified various species of skin-associated microbiota in hematoma cultures, including Cutibacterium acnes, Staphylococcus epidermidis and other Streptococcus spp.…”

Section: Discussionmentioning

confidence: 97%

“…However, prosthetic joint infection (PJI) is among the most feared complications that may result from such procedures, with an incidence of 1% to 2% among primary [1,2] and up to 4% among revision arthroplasties [3,4], respectively. Older patient age, revision arthroplasty, diabetes mellitus, rheumatoid arthritis, smoking, obesity and a high American Society of Anaesthesiologists (ASA) score are viewed as independent risk factors (RFs) for PJI [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Although few multicentre studies have described the microbiological epidemiology of PJI, the role played by GNB appears to be increasing. Rates of infections involving these organisms have ranged from 5% to 23% in previous investigations [4,7,10] but rates of greater than 40% have been reported for GNB-associated PJI in total knee arthroplasty (TKA) [11] and shoulder arthroplasty [6].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes and Risk Factors in Prosthetic Joint Infections by multidrug-resistant Gram-negative Bacteria: A Retrospective Cohort Study

Silva¹,

Salles

2021

Antibiotics

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Gram-negative bacteria (GNB), including multidrug-resistant (MDR) pathogens, are gaining importance in the aetiology of prosthetic joint infection (PJI). This retrospective observational study identified independent risk factors (RFs) associated with MDR-GNB PJI and their influence on treatment outcomes. We assessed MDR bacteria causing hip and knee PJIs diagnosed at a Brazilian tertiary hospital from January 2014 to July 2018. RFs associated with MDR-GNB PJI were estimated by bivariate and multivariate analyses using prevalence ratios (PRs) with significance at p < 0.05. Kaplan–Meier analysis was performed to evaluate treatment outcomes. Overall, 98 PJI patients were analysed, including 56 with MDR-GNB and 42 with other bacteria. Independent RFs associated with MDR-GNB PJI were revision arthroplasty (p = 0.002), postoperative hematoma (p < 0.001), previous orthopaedic infection (p = 0.002) and early infection (p = 0.001). Extensively drug-resistant GNB (p = 0.044) and comorbidities (p = 0.044) were independently associated with MDR-GNB PJI treatment failure. In sum, MDR-GNB PJI was independently associated with previous orthopaedic surgery, postoperative local complications and pre-existing infections and was possibly related to selective pressure on bacterial skin colonisation by antibiotics prescribed for early PJI. Infections due to MDR-GNB and comorbidities were associated with higher treatment failure rates.

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“…Gram-positive cocci (GPC), such as Staphylococcus aureus and coagulase-negative Staphylococci, are the major PJI-related microorganisms, followed by Gram-negative bacilli (GNB), with a prevalence ranging from 5 to 23% [4][5][6]. In some case series, PJIs attributed to GNB have been reported at rates greater than 40% [7,8].…”

Section: Introductionmentioning

confidence: 99%

Non-elective and revision arthroplasty are independently associated with hip and knee prosthetic joint infection caused by Acinetobacter baumannii: a Brazilian single center observational cohort study of 98 patients

Silva¹,

Araujo²,

Salles

2021

BMC Musculoskelet Disord

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Background Prosthetic joint infection (PJI) caused by Acinetobacter baumannii (Ab) has become a growing concern due to its overwhelming ability to express resistance to antibiotics and produce biofilm. Aim This study aimed to identify independent risk factors (RFs) associated with Ab-associated PJI and their role in the treatment outcome. Methods This was a single-centre, retrospective cohort study of PJI patients diagnosed between January 2014 and July 2018. A PJI diagnosis was made based upon the MSIS 2018 criteria. To estimate RFs associated with Ab-associated PJI, multivariate analyses with a level of significance of p < 0.05 were performed. To evaluate treatment failure, Kaplan–Meier analysis and log-rank test were performed. Results Overall, 98 PJI cases were assessed, including 33 with Ab-associated PJI and 65 with PJI involving other microorganisms (non–Ab-associated PJI). Independent RFs associated with Ab-associated PJI were revision arthroplasty [odds ratio (OR) = 3.01; 95% confidence interval (CI) = 1.15–7.90; p = 0.025] and nonelective arthroplasty (OR = 2.65; 95% CI = 1.01–7.01; p = 0.049). Ab-associated PJI was also more likely than non–Ab-associated PJI to be classified as a chronic late infection (OR = 5.81; 95% CI = 2.1–16.07; p = 0.001). Ab-associated PJI was not associated with treatment failure (p = 0.557). Conclusions Late chronic infections, surgical revision and nonelective arthroplasty are well-known predictors of PJI but were also independently associated with Ab-associated PJI. Infections caused by Ab and surgical treatment with debridement, antibiotics and implant retention were not associated with PJI treatment failure. Trial registration Study data supporting our results were registered with the Brazilian Registry of Clinical Trials (https://www.ensaiosclinicos.gov.br/rg/RBR-6ft5yb/), an open-access virtual platform for the registration of studies on humans performed in Brazil. Registration no.RBR-6ft5yb.

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Infections after shoulder arthroplasty are correlated with higher anesthetic risk score: a case-control study in Brazil

Abstract: This study provides evidence suggesting that patient-related known factors such as higher ASA score predisposes to shoulder arthroplasty-associated infection. Furthermore, unusual pathogens associated with PSI were identified.

Cited by 14 publications

References 25 publications

Surgical site infection in elective clean and clean-contaminated surgeries in developing countries

Surgical site infection in elective clean and clean-contaminated surgeries in developing countries

Outcomes and Risk Factors in Prosthetic Joint Infections by multidrug-resistant Gram-negative Bacteria: A Retrospective Cohort Study

Non-elective and revision arthroplasty are independently associated with hip and knee prosthetic joint infection caused by Acinetobacter baumannii: a Brazilian single center observational cohort study of 98 patients

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