Time trends in the aetiology of prosthetic joint infections: a multicentre cohort study
Por:
Benito, N, Franco, M, Ribera, A, Soriano, A, Rodriguez-Pardo, D, Sorli, L, Fresco, G, Fernandez-Sampedro, M, del Toro, MD, Guio, L, Sanchez-Rivas, E, Bahamonde, A, Riera, M, Esteban, J, Baraia-Etxaburu, JM, Martinez-Alvarez, J, Jover-Saenz, A, Duenas, C, Ramos, A, Sobrino, B, Euba, G, Morata, L, Pigrau, C, Coll, P, Mur, I, Ariza, J
Publicada:
1 ago 2016
Resumen:
It is important to know the spectrum of the microbial aetiology of prosthetic joint infections (PJIs) to guide empiric treatment and establish antimicrobial prophylaxis in joint replacements. There are no available data based on large contemporary patient cohorts. We sought to characterize the causative pathogens of PJIs and to evaluate trends in the microbial aetiology. We hypothesized that the frequency of antimicrobial-resistant organisms in PJIs has increased in the recent years. We performed a cohort study in 19 hospitals in Spain, from 2003 to 2012. For each 2-year period (2003-2004 to 2011-2012), the incidence of microorganisms causing PJIs and multidrug-resistant bacteria was assessed. Temporal trends over the study period were evaluated. We included 2524 consecutive adult patients with a diagnosis of PJI. A microbiological diagnosis was obtained for 2288 cases (90.6%). Staphylococci were the most common cause of infection (1492, 65.2%). However, a statistically significant rising linear trend was observed for the proportion of infections caused by Gram-negative bacilli, mainly due to the increase in the last 2-year period (25% in 2003-2004, 33.3% in 2011-2012; p 0.024 for trend). No particular species contributed disproportionally to this overall increase. The percentage of multidrug-resistant bacteria PJIs increased from 9.3% in 2003-2004 to 15.8% in 2011-2012 (p 0.008), mainly because of the significant rise in multidrug-resistant Gram-negative bacilli (from 5.3% in 2003-2004 to 8.2% in 2011-2012; p 0.032). The observed trends have important implications for the management of PJIs and prophylaxis in joint replacements. N. Benito, (C) 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Filiaciones:
Benito, N:
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Inst Invest Biomed St Pau, Hosp Santa Creu & St Pau, Infect Dis Unit, St Antoni Maria Claret 167, Barcelona 08025, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Franco, M:
Inst Invest Biomed St Pau, Hosp Santa Creu & St Pau, Infect Dis Unit, St Antoni Maria Claret 167, Barcelona 08025, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Ribera, A:
Hosp Univ Bellvitge, Dept Infect Dis, Barcelona, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Soriano, A:
Hosp Clin Univ, Dept Infect Dis, Barcelona, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Rodriguez-Pardo, D:
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Hosp Univ Vall dHebron, Dept Infect Dis, Barcelona, Spain
Sorli, L:
Hosp del Mar, Dept Infect Dis, Barcelona, Spain
Fresco, G:
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Hosp Univ Ramon & Cajal, Dept Infect Dis, Madrid, Spain
Fernandez-Sampedro, M:
Hosp Univ Valdecilla, Dept Infect Dis, Santander, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
del Toro, MD:
Hosp Univ Virgen Macarena, Dept Infect Dis, Seville, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Guio, L:
Hosp Univ Cruces, Dept Infect Dis, Bilbao, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Sanchez-Rivas, E:
Hosp Univ Virgen del Rocio, Dept Infect Dis, Seville, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Bahamonde, A:
Hosp el Bierzo, Dept Internal Med Infect Dis, Leon, Spain
Riera, M:
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Hosp Univ Son Espases, Dept Infect Dis, Infect Dis Unit, Palma de Mallorca, Spain
Esteban, J:
IIS Fundacion Jimenez Diaz, Dept Clin Microbiol, Madrid, Spain
Baraia-Etxaburu, JM:
Hosp Basurto, Dept Infect Dis, Bilbao, Spain
Martinez-Alvarez, J:
Hosp Univ Cent Asturias, Dept Internal Med, Oviedo, Spain
Jover-Saenz, A:
Hosp Arnau Vilanova, Unit Nosocomial Infect, Lleida, Spain
Duenas, C:
Hosp Univ Burgos, Dept Internal Med, Burgos, Spain
Ramos, A:
Hosp Univ Puerta Hierro, Dept Internal Med, Infect Dis Unit, Madrid, Spain
Sobrino, B:
Univ Malaga, Hosp Reg, Dept Infect Dis, Malaga, Spain
Euba, G:
Hosp Univ Bellvitge, Dept Infect Dis, Barcelona, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Morata, L:
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Hosp Clin Univ, Dept Infect Dis, Barcelona, Spain
Pigrau, C:
Hosp Univ Vall dHebron, Dept Infect Dis, Barcelona, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Coll, P:
Inst Invest Biomed St Pau, Hosp Santa Creu & St Pau, Dept Clin Microbiol, Barcelona, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Mur, I:
Inst Invest Biomed St Pau, Hosp Santa Creu & St Pau, Infect Dis Unit, St Antoni Maria Claret 167, Barcelona 08025, Spain
Ariza, J:
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015, Madrid, Spain
Hosp Univ Bellvitge, Dept Infect Dis, Barcelona, Spain
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