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Published in: Archives of Orthopaedic and Trauma Surgery 10/2016

01-10-2016 | Orthopaedic Surgery

Is the prognosis the same for periprosthetic joint infections due to Staphylococcus aureus versus coagulase-negative staphylococci? A retrospective study of 101 patients with 2-year minimum follow-up

Authors: J. Murgier, J.-M. Laffosse, J. Cailliez, E. Cavaignac, P. Murgier, X. Bayle-Iniguez, P. Chiron, P. Bonnevialle

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2016

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Abstract

Background

Staphylococcus aureus (SA) and Coagulase-negative staphylococci (CoNS) are often responsible for infections of total hip arthroplasty (THA) and total knee arthroplasty (TKA). One of the main differences between these two microorganisms is their virulence, with SA presumed to be more virulent; however, few studies have specifically investigated the impact of this virulence. This inspired us to carry out a retrospective study to evaluate whether the healing rate differed between SA and CoNS infections.

Hypothesis

We hypothesised that the healing rate is lower for SA prosthetic joint infections.

Materials and methods

This was a retrospective study of 101 consecutive Staphylococcus infection cases that occurred between 2007 and 2011. There were 56 men and 45 women with an average age of 69 years (range 23–95). The infection was associated with TKA in 38 cases and THA in 63 cases. Thirty-two percent of patients had one or more comorbidities with infectious potential. In our cohort, there were 32 SA infections (31.7 %) and 69 CoNS infections (68.3 %) with 58 of the infections being methicillin-resistant (15 SA and 43 CoNS); there were 27 polymicrobial infections (26.7 %).

Results

With a minimum 24-month follow-up after the end of antibiotic treatment, the healing rate was 70.3 % overall (71 patients). The healing rate was 75 % in the SA group (24 patients) versus 68.1 % (47 patients) in the CoNS group (P = 0.42).

Conclusion

Our hypothesis was not confirmed: the healing rate of SA prosthetic joint infections was not lower than that of CoNS infections.

Level of evidence

III, retrospective case–control study.
Literature
1.
go back to reference Parvizi J, Azzam K, Ghanem E, Austin MS, Rothman RH (2009) Periprosthetic infection due to resistant staphylococci: serious problems on the horizon. Clin Orthop Relat Res 467(7):1732–1739CrossRefPubMedPubMedCentral Parvizi J, Azzam K, Ghanem E, Austin MS, Rothman RH (2009) Periprosthetic infection due to resistant staphylococci: serious problems on the horizon. Clin Orthop Relat Res 467(7):1732–1739CrossRefPubMedPubMedCentral
2.
go back to reference Gacon G, Laurencon M, Van de Velde D, Giudicelli DP (1997) Two stages reimplantation for infection after knee arthroplasty. Apropos of a series of 29 cases. Rev Chir Orthop 83(4):313–323PubMed Gacon G, Laurencon M, Van de Velde D, Giudicelli DP (1997) Two stages reimplantation for infection after knee arthroplasty. Apropos of a series of 29 cases. Rev Chir Orthop 83(4):313–323PubMed
3.
go back to reference Jenny JY, Barbe B, Gaudias J, Boeri C, Argenson JN (2013) High infection control rate and function after routine one-stage exchange for chronically infected TKA. Clin Orthop Relat Res 471(1):238–243CrossRefPubMed Jenny JY, Barbe B, Gaudias J, Boeri C, Argenson JN (2013) High infection control rate and function after routine one-stage exchange for chronically infected TKA. Clin Orthop Relat Res 471(1):238–243CrossRefPubMed
4.
go back to reference Jenny JY, Lengert R, Diesinger Y, Gaudias J, Boeri C, Kempf JF (2014) Routine one-stage exchange for chronic infection after total hip replacement. Int Orthop 38(12):2477–2481CrossRefPubMed Jenny JY, Lengert R, Diesinger Y, Gaudias J, Boeri C, Kempf JF (2014) Routine one-stage exchange for chronic infection after total hip replacement. Int Orthop 38(12):2477–2481CrossRefPubMed
5.
go back to reference Tsukayama DT, Estrada R, Gustilo RB (1996) Infection after total hip arthroplasty. A study of the treatment of one hundred and six infections. J Bone Joint Surg Am 78(4):512–523PubMed Tsukayama DT, Estrada R, Gustilo RB (1996) Infection after total hip arthroplasty. A study of the treatment of one hundred and six infections. J Bone Joint Surg Am 78(4):512–523PubMed
6.
go back to reference Beswick AD, Elvers KT, Smith AJ, Gooberman-Hill R, Lovering A, Blom AW (2012) What is the evidence base to guide surgical treatment of infected hip prostheses? systematic review of longitudinal studies in unselected patients. BMC Med 10:18–28CrossRefPubMedPubMedCentral Beswick AD, Elvers KT, Smith AJ, Gooberman-Hill R, Lovering A, Blom AW (2012) What is the evidence base to guide surgical treatment of infected hip prostheses? systematic review of longitudinal studies in unselected patients. BMC Med 10:18–28CrossRefPubMedPubMedCentral
7.
go back to reference Jamsen E, Stogiannidis I, Malmivaara A, Pajamaki J, Puolakka T, Konttinen YT (2009) Outcome of prosthesis exchange for infected knee arthroplasty: the effect of treatment approach. Acta Orthop 80(1):67–77CrossRefPubMedPubMedCentral Jamsen E, Stogiannidis I, Malmivaara A, Pajamaki J, Puolakka T, Konttinen YT (2009) Outcome of prosthesis exchange for infected knee arthroplasty: the effect of treatment approach. Acta Orthop 80(1):67–77CrossRefPubMedPubMedCentral
8.
go back to reference Aggarwal VK, Goyal N, Deirmengian G, Rangavajulla A, Parvizi J, Austin MS (2014) Revision total knee arthroplasty in the young patient: is there trouble on the horizon? J Bone Joint Surg Am 96(7):536–542CrossRefPubMed Aggarwal VK, Goyal N, Deirmengian G, Rangavajulla A, Parvizi J, Austin MS (2014) Revision total knee arthroplasty in the young patient: is there trouble on the horizon? J Bone Joint Surg Am 96(7):536–542CrossRefPubMed
9.
go back to reference Joulie D, Girard J, Mares O et al (2011) Factors governing the healing of Staphylococcus aureus infections following hip and knee prosthesis implantation: a retrospective study of 95 patients. Orthop Traumatol Surg Res 97(7):685–692CrossRefPubMed Joulie D, Girard J, Mares O et al (2011) Factors governing the healing of Staphylococcus aureus infections following hip and knee prosthesis implantation: a retrospective study of 95 patients. Orthop Traumatol Surg Res 97(7):685–692CrossRefPubMed
10.
go back to reference Jamsen E, Huhtala H, Puolakka T, Moilanen T (2009) Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J Bone Joint Surg Am 91(1):38–47CrossRefPubMed Jamsen E, Huhtala H, Puolakka T, Moilanen T (2009) Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J Bone Joint Surg Am 91(1):38–47CrossRefPubMed
11.
go back to reference Debarge R, Nicolle MC, Pinaroli A, Ait Si Selmi T, Neyret P (2007) Surgical site infection after total knee arthroplasty: a monocenter analysis of 923 first-intention implantations. Rev Chir Orthop 93(6):582–587PubMed Debarge R, Nicolle MC, Pinaroli A, Ait Si Selmi T, Neyret P (2007) Surgical site infection after total knee arthroplasty: a monocenter analysis of 923 first-intention implantations. Rev Chir Orthop 93(6):582–587PubMed
12.
go back to reference Dumaine V, Jeanne L, Paul G et al (2007) Surveillance of operative site infections in an orthopedic and traumatology surgery department: an example of methodology. Rev Chir Orthop 93(1):30–36PubMed Dumaine V, Jeanne L, Paul G et al (2007) Surveillance of operative site infections in an orthopedic and traumatology surgery department: an example of methodology. Rev Chir Orthop 93(1):30–36PubMed
13.
go back to reference Titecat M, Senneville E, Wallet F et al (2013) Bacterial epidemiology of osteoarticular infections in a referent center: 10-year study. Orthop Traumatol Surg Res 99(6):653–658CrossRefPubMed Titecat M, Senneville E, Wallet F et al (2013) Bacterial epidemiology of osteoarticular infections in a referent center: 10-year study. Orthop Traumatol Surg Res 99(6):653–658CrossRefPubMed
15.
go back to reference Cunha M, Calsolari R (2008) Toxigenicity in Staphylococcus aureus and coagulase-negative staphylococci: epidemiological and molecular aspects. Microbiol Insights 1:13–24 Cunha M, Calsolari R (2008) Toxigenicity in Staphylococcus aureus and coagulase-negative staphylococci: epidemiological and molecular aspects. Microbiol Insights 1:13–24
16.
go back to reference Lortat-Jacob A, Desplaces N, Gaudias J et al (2002) Secondary infection of joint implants: diagnostic criteria, treatment and prevention. Rev Chir Orthop 88(1):51–61PubMed Lortat-Jacob A, Desplaces N, Gaudias J et al (2002) Secondary infection of joint implants: diagnostic criteria, treatment and prevention. Rev Chir Orthop 88(1):51–61PubMed
17.
go back to reference Klouche S, Leonard P, Zeller V et al (2012) Infected total hip arthroplasty revision: one- or two-stage procedure? Orthop Traumatol Surg Res 98(2):144–150CrossRefPubMed Klouche S, Leonard P, Zeller V et al (2012) Infected total hip arthroplasty revision: one- or two-stage procedure? Orthop Traumatol Surg Res 98(2):144–150CrossRefPubMed
18.
go back to reference Laudermilch DJ, Fedorka CJ, Heyl A, Rao N, McGough RL (2010) Outcomes of revision total knee arthroplasty after methicillin-resistant Staphylococcus aureus infection. Clin Orthop Relat Res 468(8):2067–2073CrossRefPubMedPubMedCentral Laudermilch DJ, Fedorka CJ, Heyl A, Rao N, McGough RL (2010) Outcomes of revision total knee arthroplasty after methicillin-resistant Staphylococcus aureus infection. Clin Orthop Relat Res 468(8):2067–2073CrossRefPubMedPubMedCentral
19.
go back to reference Kurd MF, Ghanem E, Steinbrecher J, Parvizi J (2010) Two-stage exchange knee arthroplasty: does resistance of the infecting organism influence the outcome? Clin Orthop Relat Res 468(8):2060–2066CrossRefPubMedPubMedCentral Kurd MF, Ghanem E, Steinbrecher J, Parvizi J (2010) Two-stage exchange knee arthroplasty: does resistance of the infecting organism influence the outcome? Clin Orthop Relat Res 468(8):2060–2066CrossRefPubMedPubMedCentral
20.
go back to reference Segawa H, Tsukayama DT, Kyle RF, Becker DA, Gustilo RB (1999) Infection after total knee arthroplasty. A retrospective study of the treatment of eighty-one infections. J Bone Joint Surg Am 81(10):1434–1445PubMed Segawa H, Tsukayama DT, Kyle RF, Becker DA, Gustilo RB (1999) Infection after total knee arthroplasty. A retrospective study of the treatment of eighty-one infections. J Bone Joint Surg Am 81(10):1434–1445PubMed
21.
go back to reference Peersman G, Laskin R, Davis J, Peterson M (2001) Infection in total knee replacement: a retrospective review of 6489 total knee replacements. Clin Orthop Relat Res 392:15–23CrossRefPubMed Peersman G, Laskin R, Davis J, Peterson M (2001) Infection in total knee replacement: a retrospective review of 6489 total knee replacements. Clin Orthop Relat Res 392:15–23CrossRefPubMed
22.
go back to reference Jackson WO, Schmalzried TP (2000) Limited role of direct exchange arthroplasty in the treatment of infected total hip replacements. Clin Orthop Relat Res 381:101–105CrossRefPubMed Jackson WO, Schmalzried TP (2000) Limited role of direct exchange arthroplasty in the treatment of infected total hip replacements. Clin Orthop Relat Res 381:101–105CrossRefPubMed
23.
go back to reference Ibrahim MS, Raja S, Khan MA, Haddad FS (2014) A multidisciplinary team approach to two-stage revision for the infected hip replacement: a minimum five-year follow-up study. Bone Joint J 96-B(10):1312–1318CrossRefPubMed Ibrahim MS, Raja S, Khan MA, Haddad FS (2014) A multidisciplinary team approach to two-stage revision for the infected hip replacement: a minimum five-year follow-up study. Bone Joint J 96-B(10):1312–1318CrossRefPubMed
24.
go back to reference Wolf M, Clar H, Leithner A, Sadoghi P (2014) Prosthetic joint infection following total hip replacement. Int Orthop 38(7):2429–2430CrossRefPubMed Wolf M, Clar H, Leithner A, Sadoghi P (2014) Prosthetic joint infection following total hip replacement. Int Orthop 38(7):2429–2430CrossRefPubMed
25.
go back to reference Kaminski A, Citak M, Schildhauer TA, Fehmer T (2014) Success rates for initial eradication of peri-prosthetic knee infection treated with a two-stage procedure. Orthop Traumatol Rehabil 16(1):11–16CrossRef Kaminski A, Citak M, Schildhauer TA, Fehmer T (2014) Success rates for initial eradication of peri-prosthetic knee infection treated with a two-stage procedure. Orthop Traumatol Rehabil 16(1):11–16CrossRef
26.
go back to reference Zimmerli W (2014) Clinical presentation and treatment of orthopaedic implant-associated infection. J Intern Med 276(2):111–119CrossRefPubMed Zimmerli W (2014) Clinical presentation and treatment of orthopaedic implant-associated infection. J Intern Med 276(2):111–119CrossRefPubMed
27.
go back to reference Zeller V, Lhotellier L, Marmor S et al (2014) One-stage exchange arthroplasty for chronic periprosthetic hip infection: results of a large prospective cohort study. J Bone Joint Surg Am 96(1):e1CrossRefPubMed Zeller V, Lhotellier L, Marmor S et al (2014) One-stage exchange arthroplasty for chronic periprosthetic hip infection: results of a large prospective cohort study. J Bone Joint Surg Am 96(1):e1CrossRefPubMed
28.
go back to reference Stavrakis AI, Niska JA, Shahbazian JH et al (2014) Combination prophylactic therapy with rifampin increases efficacy against an experimental Staphylococcus epidermidis subcutaneous implant-related infection. Antimicrob Agents Chemother 58(4):2377–2386CrossRefPubMedPubMedCentral Stavrakis AI, Niska JA, Shahbazian JH et al (2014) Combination prophylactic therapy with rifampin increases efficacy against an experimental Staphylococcus epidermidis subcutaneous implant-related infection. Antimicrob Agents Chemother 58(4):2377–2386CrossRefPubMedPubMedCentral
29.
go back to reference Niska JA, Shahbazian JH, Ramos RI, Francis KP, Bernthal NM, Miller LS (2013) Vancomycin-rifampin combination therapy has enhanced efficacy against an experimental Staphylococcus aureus prosthetic joint infection. Antimicrob Agents Chemother 57(10):5080–5086CrossRefPubMedPubMedCentral Niska JA, Shahbazian JH, Ramos RI, Francis KP, Bernthal NM, Miller LS (2013) Vancomycin-rifampin combination therapy has enhanced efficacy against an experimental Staphylococcus aureus prosthetic joint infection. Antimicrob Agents Chemother 57(10):5080–5086CrossRefPubMedPubMedCentral
30.
go back to reference Whiteside LA, Peppers M, Nayfeh TA, Roy ME (2011) Methicillin-resistant Staphylococcus aureus in TKA treated with revision and direct intra-articular antibiotic infusion. Clin Orthop Relat Res 469(1):26–33CrossRefPubMed Whiteside LA, Peppers M, Nayfeh TA, Roy ME (2011) Methicillin-resistant Staphylococcus aureus in TKA treated with revision and direct intra-articular antibiotic infusion. Clin Orthop Relat Res 469(1):26–33CrossRefPubMed
31.
go back to reference Salgado CD, Dash S, Cantey JR, Marculescu CE (2007) Higher risk of failure of methicillin-resistant Staphylococcus aureus prosthetic joint infections. Clin Orthop Relat Res 461:48–53PubMed Salgado CD, Dash S, Cantey JR, Marculescu CE (2007) Higher risk of failure of methicillin-resistant Staphylococcus aureus prosthetic joint infections. Clin Orthop Relat Res 461:48–53PubMed
32.
go back to reference Vielpeau C, Hulet C, Michaut M, Acquitter Y, Pegoix M (2002) Facteurs discriminants entre les techniques en 1 temps et 2 temps. Rev Chir Orthop 86:180–182 Vielpeau C, Hulet C, Michaut M, Acquitter Y, Pegoix M (2002) Facteurs discriminants entre les techniques en 1 temps et 2 temps. Rev Chir Orthop 86:180–182
33.
go back to reference Tornero E, Garcia-Oltra E, Garcia-Ramiro S et al (2012) Prosthetic joint infections due to Staphylococcus aureus and coagulase-negative staphylococci. Int J Artif Organs 35(10):884–892PubMed Tornero E, Garcia-Oltra E, Garcia-Ramiro S et al (2012) Prosthetic joint infections due to Staphylococcus aureus and coagulase-negative staphylococci. Int J Artif Organs 35(10):884–892PubMed
34.
go back to reference Lutro O, Langvatn H, Dale H et al (2014) Increasing resistance of coagulase-negative staphylococci in total hip arthroplasty infections: 278 THA-revisions due to infection reported to the Norwegian Arthroplasty Register from 1993 to 2007. Adv Orthop 2014:580359CrossRefPubMedPubMedCentral Lutro O, Langvatn H, Dale H et al (2014) Increasing resistance of coagulase-negative staphylococci in total hip arthroplasty infections: 278 THA-revisions due to infection reported to the Norwegian Arthroplasty Register from 1993 to 2007. Adv Orthop 2014:580359CrossRefPubMedPubMedCentral
35.
Metadata
Title
Is the prognosis the same for periprosthetic joint infections due to Staphylococcus aureus versus coagulase-negative staphylococci? A retrospective study of 101 patients with 2-year minimum follow-up
Authors
J. Murgier
J.-M. Laffosse
J. Cailliez
E. Cavaignac
P. Murgier
X. Bayle-Iniguez
P. Chiron
P. Bonnevialle
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 10/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-016-2533-6

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