Successful treatment of prosthetic joint infection with multidrug-resistant Acinetobacter species with debridement and retention: a case report

Silva, Rnd De; Jayatilleke, SK; A, Perera

doi:10.4038/sljid.v6i1.8104

Cited by 1 publication

(3 citation statements)

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“…Surprisingly, in our department, we encountered four cases of A. baumannii PJI within a one-year period. The high proportion of PJIs due to A. baumannii , compared to other pathogens, in our study contrasts with the data from other large epidemiological studies [ 6 , 7 , 11 ]. This could be attributed to contamination by A. baumannii of the surfaces in hospital rooms, such as beds, tables, sinks, medical devices, floor, and walls.…”

Section: Discussioncontrasting

confidence: 99%

“…An increasing number of infections caused by this microorganism has been recorded over the last three decades. Meanwhile, there has been a dramatic increase of antibiotic-resistant strains of the pathogen, limiting antibiotic treatment options for infection and posing a challenge to clinicians [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The DAIR is not recommended if the interval between the onset of the infection and the debridement is more than four weeks. Complete removal of the prosthesis is necessary for patients with a longer duration of symptoms and when a mature biofilm is formed around the implant [ 3 , 11 ]. The establishment of a biofilm around a prosthesis contributes to the extensive dissemination of MDR strains of gram-negative bacteria.…”

Section: Discussionmentioning

confidence: 99%

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Acute Periprosthetic Hip Joint Infection Caused by Multidrug-Resistant Acinetobacter Baumannii: Is Debridement, Antibiotics, Irrigation, and Implant Retention a Viable Treatment Option?

Vasiliadis

Poutoglidou

Chatziravdeli

et al. 2021

Cureus

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In this study, we aimed to investigate the effectiveness of debridement, antibiotics, irrigation, and implant retention (DAIR) in periprosthetic hip joint infection caused by multidrug-resistant (MDR) Acinetobacter baumannii (A. baumannii) . From July 2019 to June 2020, we retrospectively reviewed all patients treated for periprosthetic hip joint infections caused by MDR A. baumannii at our institution. The diagnosis of periprosthetic joint infection (PJI) was established based on the Musculoskeletal Infection Society (MSIS) 2018 criteria. The Charlson Comorbidity Index (CCI) was used to estimate the risk of mortality. The patients were followed up for over a year, until their death, or loss to follow-up. Four patients (three females and one male), with a mean age of 68 years, were included in the study. A. baumannii exhibited resistance to fluoroquinolones in all cases. All patients were treated with the DAIR procedure followed by intravenous tigecycline and colistin combination treatment. Prosthesis retention with good functional results was achieved in two patients. One patient required resection arthroplasty and one patient died two months after the initial surgical treatment, yielding a success rate of 50% for the DAIR procedure. Periprosthetic hip joint infection caused by MDR A. baumannii is one of the most demanding and challenging complications in orthopaedic practice. This case series suggests that the outcome of the DAIR is affected by a number of factors that are in a complex interplay. Our results indicate a limited success rate for the DAIR procedure in the treatment of a periprosthetic hip joint infection caused by MDR A. baumannii .

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%