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The Different Microbial Etiology of Prosthetic Joint Infections According to Route of Acquisition and Time After Prosthesis Implantation, Including the Role of Multidrug-Resistant Organisms

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.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: J Clin Med . 2019 May 13;8(5):673

Editorial: MDPI AG

 Año de publicación: 2019

Nº de páginas: 15

Tipo de publicación: Artículo de Revista

 DOI: 10.3390/jcm8050673

ISSN: 2077-0383

Url de la publicación: https://www.doi.org/10.3390/jcm8050673

Autores/as

BENITO, NATIVIDAD

MUR, ISABEL

RIBERA, ALBA

SORIANO, ALEX

RODRÍGUEZ-PARDO, DOLORS

SORLÍ, LUISA

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