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International Orthopaedics

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01-06-2017 | Original Paper

Chronic periprosthetic hip infection: micro-organisms responsible for infection and re-infection

Authors: Nikolai M. Kliushin, Artem M. Ermakov, Tatiana A. Malkova

Published in: International Orthopaedics | Issue 6/2017

Abstract

Purpose

This study aimed to delineate the infecting micro-organisms identified at the first-time revision for infected THA, analyze pre-operative versus intra-operative findings, as well as intra-operative ones against re-infection micro-organisms.

Material and methods

Microbiological laboratory findings were studied in 73 patients (mean age, 51.93 ± 10.9 years) with chronic periprosthetic hip infection pre-operatively and intra-operatively. Forty-three patients had a two-stage revision THA while 30 patients were treated with a modified resection arthroplasty using the Ilizarov apparatus. Re-infection developed in 29 cases. Its microbial species were identified.

Results

Pre-operative findings on micro-organisms coincided 50.7 % with the intra-operative ones. Bacterial growth in the intra-operative tests was detected in 72 (98.5 %) cases. Gram-positive single genus infection was identified in 35 patients (48 %); microbe associations were present in 33 patients (45 %). Staphylococcus species prevailed. Gram-negative infection was detected in 5.5 % of cases. One case (1.5 %) did not have any microbe growth. Re-infection happened in 10 cases (23.2 %) in a two-stage revision THA. In the resection arthroplasty group, early re-infection was observed in 63.3 % of cases. Among a total of 29 re-infection cases, staphylococcus species were identified in 19 cases, present either in associations or as single germs.

Conclusion

Intra-operative microbiological tests at the first-time revision for infected THR detect a reliable spectrum of micro-organisms to assess microbial resistance to antibiotics, develop treatment protocols, and for prognostic purposes. Preventive measures at primary THR and strategies to fight periprosthetic infection and reinfection should be targeted on staphylococci.

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Title: Chronic periprosthetic hip infection: micro-organisms responsible for infection and re-infection
Authors: Nikolai M. Kliushin
Artem M. Ermakov
Tatiana A. Malkova
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 6/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-016-3341-x

At a glance: The STEP trials

Springer Medicine

Chronic periprosthetic hip infection: micro-organisms responsible for infection and re-infection

Abstract

Purpose

Material and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Material and methods

Results

Conclusion

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