Second-site prosthetic joint infection in patients with multiple prosthetic joints

Clesham, Kevin; Hughes, Andrew; hEireamhoin, S O; Fleming, Catherine; Murphy, Colin G.

doi:10.1007/s00590-018-2189-8

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…Interestingly, we observed just two cases of re-infection at the same site by a different pathogen [ 3 , 26 ] since it is usually reported that high virulence microorganisms can promote reinfection with the same pathogen [ 27 ]. Here, we reported a re-infection at the same site by Abiotrophia defectiva and Finegoldia magna after successfully treating Staphylococcus warneri and Staphylococcus aureus infections, respectively.…”

Section: Discussionmentioning

confidence: 99%

Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review

et al. 2022

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Orthopedic and trauma device-related infections (ODRI) due to high virulence microorganisms are a devastating complication after orthopedic surgery. Coagulase-negative Staphylococci (CoNS) are mainly involved but commensal bacteria, located in human mucous membranes, are emerging pathogens in ODRI. Currently, bacterial culture is the gold standard for ODRI but the diagnostic process remains time consuming and laborious. We evaluated a combination of microbiological approaches in the diagnosis of emerging pathogens involved in ODRI. We analyzed two synovial fluids, five tissue samples and five surgical wound swabs from two different patients with ODRI, attending the Department of Orthopedic and Trauma Surgery of Mater Domini Teaching Hospital, Catanzaro, Italy. Identification was carried out with a combination of microbiological approaches (culture, mass spectrometry and 16s rRNA gene sequencing). We demonstrated the importance of a combination of microbiological approaches for the diagnosis of emerging pathogens in ODRI, because the low number of cases in the literature makes it very difficult to formulate guidelines for the management of patients.

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Section: Discussionmentioning

confidence: 99%

Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review

et al. 2022

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“…PJI, as defined by MSIS criteria in this report, are a potentially devastating complication of TJA78). Although there is abundant literature available on primary PJI, the risk factors and clinical outcomes for multiple PJI are less well understood91011). A limited set of case series have estimated the risk of multiple PJI to be between 6.3% to 20% after the development of an index infection in patients with multiple TJA611121314).…”

Section: Discussionmentioning

confidence: 90%

“…In patients with multiple PJI, the large majority of observed infections are likely to be metachronic rather than synchronic1112131415). For example, Jafari et al13) retrospectively observed a population with multiple PJI and found a mean time to second infection of 2.0 years (range, 0–6.88 years) with only 3% of patients in the study suffering from synchronic PJI.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is abundant literature available on primary PJI, the risk factors and clinical outcomes for multiple PJI are less well understood91011). A limited set of case series have estimated the risk of multiple PJI to be between 6.3% to 20% after the development of an index infection in patients with multiple TJA611121314). Acute hematogenous spread has been described as the most likely mode of secondary infection in patients with metachronic or synchronic PJI1415).…”

Section: Discussionmentioning

confidence: 99%

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Three Concurrent Periprosthetic Joint Infections: A Case Report and Literature Review

et al. 2019

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Periprosthetic joint infections are a major cause of morbidity and mortality following total joint arthroplasty. Two-stage arthroplasty, with the use of an antibiotic cement spacer, is an effective means of managing periperiprosthetic joint infections. There is a lack of data relating to the management, prognosis, and clinical outcomes associated with multiple peri-prosthetic joint infections. Here, we present a case report of a patient successfully treated for three synchronic peri-prosthetic joint infections of both knees and a single hip.

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“…The authors attributed the lower rate of eradication of MRSA estimated at 40 to 80%, 21 even in a two-stage resection arthroplasty, to the increased risk of developing a second PJI. Clesham et al 22 identified MRSA and longer hospital length of stay as risk factors for MPJI; the authors also noted that an index infection of a knee prosthesis was associated with a higher risk of developing a second site infection compared with an index hip prosthesis infection. The authors found no correlation between diabetes, chronic obstructive pulmonary disease, hypertension, atrial fibrillation, RA or ischemic heart disease, and the risk of a second MPJI.…”

Section: Risk Factors For Metachronous Periprosthetic Joint Infectionmentioning

confidence: 99%

Periprosthetic Infection in Patients With Multiple Joint Arthroplasties

Mansour,

Clarke,

Spangehl

et al. 2023

J Am Acad Orthop Surg

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The number of total joint arthroplasties performed in the United States is increasing every year. Owing to the aging population and excellent long-term prosthesis survival, 45% of patients who undergo joint arthroplasty will receive two or more joint arthroplasties during their lifetimes. Periprosthetic joint infection (PJI) is among the most common complications after arthroplasty. Evaluation and treatment of PJI in patients with multiple joint arthroplasties is challenging, and no consensus exists for the optimal management. Multiple PJI can occur simultaneously, synchronous, or separated by extended time, metachronous. Patient risk factors for both scenarios have been reported and may guide evaluation and long-term management. Whether to perform joint aspiration for asymptomatic prosthesis in the presence of suspected PJI in patients with multiple joint arthroplasties is controversial. Furthermore, no consensus exists regarding whether patients who have multiple joint arthroplasties and develop PJI in a single joint should be considered for prolonged antibiotic prophylaxis to reduce the risk of future infections. Finally, the optimal treatment of synchronous joint infections whether by débridement, antibiotics and implant retention, and one-stage or two-stage revision has not been defined. This review will summarize the best information available and provide pragmatic management strategies.

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Second-site prosthetic joint infection in patients with multiple prosthetic joints

Cited by 5 publications

References 29 publications

Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review

Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review

Three Concurrent Periprosthetic Joint Infections: A Case Report and Literature Review

Periprosthetic Infection in Patients With Multiple Joint Arthroplasties

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