Microbiological Etiology of Prosthetic Joint Infections
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 12
Abstract
Introduction: Infection of the prosthesis remains one of the most devastating complications of arthroplasty surgery. Identification of the likely cause of early-onset PJI is particularly important given that these infections are more frequently treated with a debridement procedure where the implant is not removed. Aim and objectives: To identify the microbiological aetiology of prosthetic joint infections and to identify the antimicrobial susceptibility pattern in order to propose the treatment guidelines of PJI based on the duration of onset of symptoms. Material and methods: Synovial fluid collected preoperatively, periprosthetic tissue and the removed prosthesis were processed following standard laboratory protocols set up by the Mayo Clinic. Results:The primary gram stain from culture positive samples was positive in 81/111 (72.97%) samples. Gram negative bacteria constituted majority of the isolates (57/75) (76%) identified from early onset of infection of which Acinetobacter baumannii was the commonest and was significantly associated with early onset infection, while MRSA was associated significantly with delayed onset infection and CONS was significantly associated with late onset infection. Discussion: This study highlights the importance of gram negative pathogens (76%) in early onset of infection, which showed a high incidence of resistance to β lactam and β lactam inhibitor combinations which might be due to the high incidence of ESBL in both community and hospital acquired infections. Multi-drug resistance among the isolates advocates the case for reconsideration of existing protocols for surgeries involving prosthesis which might potentially decrease the incidence of PJIs and reduce patient morbidity and mortality. Treatment modalities can be determined based upon the database generated in individual institutions
Authors and Affiliations
Simit Kumar, Maitreyi Bandyopadhyay, Abhishek Sengupta, Nivedita Bhattacharjee, Manas Kumar Bandyopadhyay, Prabir Kumar Mukhopadhyay, Anindita Chatterjee, Mitali Chatterjee
Keywords
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- EP ID EP251514
- DOI 10.9790/0853-1612108589
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