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Abstract: The aim of our study was to characterize the etiology of prosthetic joint infections (PJIs)-including multidrug-resistant organisms (MDRO)-by category of infection. A multicenter study of 2544 patients with PJIs was performed. We analyzed the causative microorganisms according to the Tsukayama's scheme (early postoperative, late chronic, and acute hematogenous infections (EPI, LCI, AHI) and "positive intraoperative cultures" (PIC)). Non-hematogenous PJIs were also evaluated according to time since surgery: <1 month, 2-3 months, 4-12 months, >12 months. AHIs were mostly caused by Staphylococcus aureus (39.2%) and streptococci (30.2%). EPIs were characterized by a preponderance of virulent microorganisms (S. aureus, Gram-negative bacilli (GNB), enterococci), MDROs (24%) and polymicrobial infections (27.4%). Conversely, coagulase-negative staphylococci (CoNS) and Cutibacterium species were predominant in LCIs (54.5% and 6.1%, respectively) and PICs (57.1% and 15.1%). The percentage of MDROs isolated in EPIs was more than three times the percentage isolated in LCIs (7.8%) and more than twice the proportion found in AHI (10.9%). There was a significant decreasing linear trend over the four time intervals post-surgery for virulent microorganisms, MDROs, and polymicrobial infections, and a rising trend for CoNS, streptococci and Cutibacterium spp. The observed differences have important implications for the empirical antimicrobial treatment of PJIs.
Fuente: J Clin Med . 2019 May 13;8(5):673
Publisher: MDPI AG
Year of publication: 2019
No. of pages: 15
Publication type: Article
DOI: 10.3390/jcm8050673
ISSN: 2077-0383
Publication Url: https://www.doi.org/10.3390/jcm8050673
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BENITO, NATIVIDAD
MUR, ISABEL
RIBERA, ALBA
SORIANO, ALEX
RODRÍGUEZ-PARDO, DOLORS
SORLÍ, LUISA
COBO,JAVIER
MARTA FERNANDEZ SAMPEDRO
TORO, MARÍA DOLORES DEL
GUÍO, LAURA
PRAENA, JULIA
BAHAMONDE, ALBERTO
RIERA, MELCHOR
ESTEBAN, JAIME
MIRENA BARAIA-ETXABURU, JOSU
MARTÍNEZ-ALVAREZ, JESÚS
JOVER-SÁENZ, ALFREDO
DUEÑAS, CARLOS
RAMOS, ANTONIO
SOBRINO, BEATRIZ
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