Occurrence of Rare Pathogens at the Site of Periprosthetic Hip and Knee Joint Infections: A Retrospective, Single-Center Study

Abstract

The frequency and clinical relevance of rare pathogens at the site of periprosthetic infections of the hip and knee joint and their antibiotic resistance profiles have not yet been assessed in-depth. We retrospectively analyzed all periprosthetic hip and knee joint infections that occurred between 2016 and 2020 in a single center in southwest Germany. Among 165 infections, 9.7% were caused by rare microorganisms such as Veilonella sp., Pasteurella sp., Pantoea sp., Citrobacter koseri, Serratia marcescens, Parvimonas micra, Clostridium difficile, Finegoldia magna, Morganella morganii, and yeasts. No resistance to piperacillin/tazobactam, carbapenemes, fluoroquinolones, or gentamicin was observed. Some bacteria displayed resistance to ampicillin, ampicillin/sulbactam, and cefuroxime. We present follow-up data of patients with infections due to rare pathogens and discuss the importance of close, interdisciplinary collaboration between orthopedic surgeons and clinical microbiologists to carefully select the most appropriate anti-infective treatment regimens for the increasing number of patients with such infections.

Diagnosis of orthopaedic-implant-associated infections caused by slow-growing Gram-positive anaerobic bacteria – a clinical perspective

“…The method of collection and the number of samples collected can affect the culture results. To optimize the chance of culturing bacteria, antibiotic pause 2 weeks preoperatively and prophylactic antibiotics withheld until the samples are collected are often applied, although the value in SGAB IAI has not been investigated (Atkins et al, 1998). Multiple samples, also more than normal, may be required in SGAB due to a combination of low bacterial burden and uneven distribution of bacteria in the peri-implant tissues, as well as the risk of contamination in the processing of the samples (Atkins et al, 1998;Mc-Goldrick et al, 2015).…”

“…To optimize the chance of culturing bacteria, antibiotic pause 2 weeks preoperatively and prophylactic antibiotics withheld until the samples are collected are often applied, although the value in SGAB IAI has not been investigated (Atkins et al, 1998). Multiple samples, also more than normal, may be required in SGAB due to a combination of low bacterial burden and uneven distribution of bacteria in the peri-implant tissues, as well as the risk of contamination in the processing of the samples (Atkins et al, 1998;Mc-Goldrick et al, 2015). The current IDSA guidelines recommend at least three and optimally five or six samples with two positive cultures for a definitive diagnosis (Kamme and Lindberg, 1981;Osmon et al, 2013).…”

Antibiotic Prophylaxis in One-Stage Revision of Septic Total Knee Arthroplasty: A Scoping Review

“…Nickinson et al, in their study, described the occurrence of coagulase-negative staphylococci dominating the group examined (49%) [ 47 , 48 ].…”

Design and Implementation of Athlete’s Knee Health Monitoring System Based on Cloud Computing

“…In order to solve the disadvantages of waste of resources and poor flexibility of hot deployment, we use the scalable hot deployment method, which can deploy without interrupting the operation of web server, which greatly improves the development efficiency. The main functions of the intelligent monitoring system designed in this paper include receiving monitoring data in real-time, dynamically displaying data, analyzing the legiti-macy of verification data, querying historical data, and other functional modules and can give a comprehensive health status detection report for the measurement results of different data according to the standard reference value of vital signs data within the normal range [14].…”