Successful outcome for patients with streptococcal prosthetic joint infections – a retrospective population-based study

Lam, Anny; Rasmussen, Magnus; Thompson, Olof

doi:10.1080/23744235.2018.1449961

Cited by 17 publications

(16 citation statements)

References 28 publications

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“…However only few cases had this course of treatment. When comparing with other common pathogens, we found that the cure rate of 72% for DAIR-treated cases was well in line with treatment outcomes for staphylococci (55-88%) and streptococci (75-84%) [9,10,17,18]. However, we did not compare PJIs caused by these pathogens and we found no other studies comparing enterococcal PJI with staphylococcal or streptococcal PJI either.…”

Section: Discussionmentioning

confidence: 68%

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A population-based study on the treatment and outcome of enterococcal prosthetic joint infections. A consecutive series of 55 cases

Thompson

Rasmussen

Stefánsdóttir

et al. 2019

J. Bone Joint Infect.

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Abstract. AIM: Enterococci cause 2-11% of all prosthetic joint infections (PJI) and are generally considered difficult to treat. However, study-results are not consistent. In this study we present a population-based case series of 55 cases with enterococcal PJI, investigating treatment and outcome, as well as describing the affected patient population regarding demography and co-morbidities.METHODS: We identified all enterococcal PJIs in the Region of Skåne, Sweden, during a five-year period (2011-2015) and reviewed the patients' medical records.RESULTS: Fifty-five enterococcal PJIs were found. Enterococcus faecalis was the most frequently isolated species (84%), and poly-microbial infections were common (64%). Treatment with intention to cure was given to 43 (78%) cases. Debridement with retention of the implant and antibiotics (DAIR) was the most common surgical treatment strategy (71%), with a cure-rate of 72%. Overall cure-rate was 67%, and in cases where cure was intended, this was achieved in 80%.CONCLUSIONS: When cure is aimed for, the prognosis for enterococcal PJI is not so poor, and DAIR treatment can provide adequate results in many cases.

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Section: Discussionmentioning

confidence: 68%

“…Enterococcal PJIs are frequently poly-microbial, and have been associated with a higher failure rate than both staphylococcal and streptococcal PJIs [7,9,10]. Two-stage exchange of infected prostheses is therefore the generally recommended surgical treatment modality, and one-stage exchange is considered contraindicated [5,11].…”

Section: Introductionmentioning

confidence: 99%

A population-based study on the treatment and outcome of enterococcal prosthetic joint infections. A consecutive series of 55 cases

Thompson

Rasmussen

Stefánsdóttir

et al. 2019

J. Bone Joint Infect.

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Section: Introductionmentioning

confidence: 99%

“…The success rate of DAIR for treating periprosthetic infection caused by Streptococcus is relatively high [ 27 , 28 ]. Lam et al [ 27 ] reported that the initial success rate of DAIR in the treatment of 53 PJI cases caused by Streptococcus infection was 84%. However, in 2017, a large multicenter retrospective study showed that the success rate of DAIR for Streptococcus infection was only 57.9% [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors affect success rate of debridement, antibiotics and implant retention (DAIR) in periprosthetic joint infection

Wang

2020

Arthroplasty

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Background Periprosthetic joint infection (PJI) is the most devastating complication of joint replacement that seriously affects the quality of life and causes a heavy burden to the families and society. Due to shorter hospital stays, lower costs, improved joint function and less morbidity, a process of debridement, antibiotics and implant retention (DAIR) is recommended as the preferred treatment for acute periprosthetic joint infection. However, the factors that impact the success rate of DAIR remain controversial. This article evaluates the influential factors of DAIR and provides insights for orthopaedics surgeons to make optimal decisions to improve the success rate of DAIR. Conclusion The poor general condition of patients, high preoperative C-reactive protein (CRP) level, repeated joint surgeries, and Methicillin-resistant Staphylococcus aureus (MRSA) infections may be associated with lower DAIR success rate. To the contrary, early surgery, radical debridement, exchange of removable components, washing with iodine and vacuum sealing drainage (VSD) may improve the success rate of DAIR. A sinus tract may not be absolutely contraindicated, but surgeons should treat it with caution. As there is no consensus on many issues, more high-quality research is required.

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“…When prosthetic infection has been diagnosed, whether group G streptococcal infection or otherwise, standard practice has been to undergo open irrigation and debridement with potential explant. However, new literature has demonstrated successful treatment of streptococcal joint infection with the more conservative debridement, antibiotics, and implant retention technique [18]. In addition, Burkert and Watanakunakorn found that only 1 in 13 patients with group G streptococcal PJI required explant [19].…”

Section: Discussionmentioning

confidence: 99%

Hair of the Dog? Periprosthetic Joint Infection with Streptococcus canis

2021

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A 61-year-old man underwent elective primary total hip arthroplasty at an academic center and presented to the emergency department 2 weeks later with a periprosthetic infection. Intraoperative cultures were positive for Streptococcus canis. He was successfully treated with one-stage revision and 6 weeks of intravenous cefazolin. It was later determined that the patient has a pet dog who frequently licks his legs. We hypothesize that patients with pets are more likely to carry this pathogen as part of their skin microbiome, and further research is required to establish whether S. canis poses an infectious risk beyond that of normal group B Streptococcus skin flora and if preoperative decolonization strategies are warranted.

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Successful outcome for patients with streptococcal prosthetic joint infections – a retrospective population-based study

Abstract: This study indicates an acceptable success rate for the patients treated with DAIR strategy, and a high overall success rate for episodes suffering streptococcal PJIs.

Cited by 17 publications

References 28 publications

A population-based study on the treatment and outcome of enterococcal prosthetic joint infections. A consecutive series of 55 cases

A population-based study on the treatment and outcome of enterococcal prosthetic joint infections. A consecutive series of 55 cases

Risk factors affect success rate of debridement, antibiotics and implant retention (DAIR) in periprosthetic joint infection

Hair of the Dog? Periprosthetic Joint Infection with Streptococcus canis

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