How to Handle Concomitant Asymptomatic Prosthetic Joints During an Episode of Hematogenous Periprosthetic Joint Infection, a Multicenter Analysis
Por:
Wouthuyzen-Bakker, M, Sebillotte, M, Arvieux, C, Fernandez-Sampedro, M, Senneville, E, Barbero, JM, Lora-Tamayo, J, Aboltins, C, Trebse, R, Salles, MJ, Kramer, TS, Ferrari, M, Garcia-Canete, J, Benito, N, Diaz-Brito, V, Del Toro, MD, Scarborough, M, Soriano, A
Publicada:
1 dic 2021
Resumen:
Background. Prosthetic joints are at risk of becoming infected during an episode of bacteremia, especially during Staphylocococcus aureus bacteremia. However, it is unclear how often asymptomatic periprosthetic joint infection (PJI) occurs, and whether additional diagnostics should be considered.
Methods. In this multicenter study, we retrospectively analyzed a cohort of patients with a late acute (hematogenous) PJI between 2005-2015 who had concomitant prosthetic joints in situ. Patients without at least 1 year of follow-up were excluded.
Results. We included 91 patients with a hematogenous PJI and 108 concomitant prosthetic joints. The incident PJI was most frequently caused by Staphylococcus aureus (43%), followed by streptococci (26%) and Gram-negative rods (18%). Of 108 concomitant prosthetic joints, 13 were symptomatic, of which 10 were subsequently diagnosed as a second PJI. Of the 95 asymptomatic prosthetic joints, 1 PJI developed during the follow-up period and was classified as a "missed" PJI at the time of bacteremia with S. aureus (1.1%). Infected prosthetic joints were younger than the noninfected ones in 67% of cases, and prosthetic knees were affected more often than prosthetic hips (78%).
Conclusions. During an episode of hematogenous PJI, concomitant asymptomatic prosthetic joints have a very low risk of being infected, and additional diagnostic work-up for these joints is not necessary.
Filiaciones:
Wouthuyzen-Bakker, M:
Univ Groningen, Univ Med Ctr Groningen, Dept Med Microbiol & Infect Prevent, Groningen, Netherlands
Sebillotte, M:
Rennes Univ Hosp, Dept Infect Dis & Intens Care Med, Rennes, France
Arvieux, C:
Rennes Univ Hosp, Dept Infect Dis & Intens Care Med, Rennes, France
Great West Reference Ctr Complex Bone & Joint Inf, Rennes, France
Fernandez-Sampedro, M:
Univ Cantabria, Hosp Univ Marques Valdecilla, Inst Invest Sanitaria Valdecilla IDIVAL, Serv Infect Dis, Santander, Spain
Senneville, E:
Gustave Dron Hosp, Univ Hosp, Dept Infect Dis, Tourcoing, France
Barbero, JM:
Hosp Univ Principe Asturias, Dept Internal Med, Madrid, Spain
Lora-Tamayo, J:
Hosp Univ 12 Octubre, Inst Invest I 12, Dept Internal Med, Madrid, Spain
Aboltins, C:
Northern Hlth, Dept Infect Dis, Melbourne, Vic, Australia
Univ Melbourne, Northern Clin Sch, Melbourne, Vic, Australia
Trebse, R:
Univ Ljublijana, Valdoltra Orthopaed Hosp, Fac Med, Serv Bone Infect, Ankaran, Slovenia
Salles, MJ:
Univ Fed Sao Paulo, Santa Casa Sao Paulo Sch Med Sci, Sao Paulo, Brazil
Univ Fed Sao Paulo, Musculoskeletal Infect Grp, Sao Paulo, Brazil
Kramer, TS:
Charite Univ Med Berlin, Inst Hyg & Environm Med, Berlin, Germany
Evangel Waldkrankenhaus Spandau, Berlin, Germany
Ferrari, M:
Humanitas Univ, Dept Biomed Sci, Milan, Italy
Ist Ricovero & Cura Carattere Sci IRCCS, Humanitas Res Hosp, Milan, Italy
Garcia-Canete, J:
Univ Autonoma Madrid UAM, Fdn Jimenez Diaz, Inst Invest Sanitaria IIS, Dept Internal Med Emergency, Madrid, Spain
Benito, N:
Hosp Santa Creu & Sant Pau, Inst Invest Biomed St Pau, Infect Dis Unit, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Diaz-Brito, V:
Parc Sanitari St Joan Deu, Infect Dis Unit, Barcelona, Spain
Del Toro, MD:
Univ Seville, Unidad Clin Enfermedades Infecciosa & Microbiol, Inst Biomed Sevilla IBIS, Seville, Spain
Scarborough, M:
Oxford Univ Hosp Natl Hlth Serv NHS Fdn Trust, Nuffield Orthopaed Ctr, Bone Infect Unit, Oxford, England
Soriano, A:
Univ Barcelona, Hosp Clin, Serv Infect Dis, Barcelona, Spain
Green Published
|