Top

Archives of Orthopaedic and Trauma Surgery

Published in:

Open Access 01-09-2019 | Gentamicin | Orthopaedic Surgery

Staphylococcal resistance profiles in deep infection following primary hip and knee arthroplasty: a study using the NJR dataset

Authors: Richard J. Holleyman, David J. Deehan, Lucy Walker, Andre Charlett, Julie Samuel, Mark D. F. Shirley, Paul N. Baker

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2019

Abstract

Introduction

This study aimed to (1) report the rates of resistance against a variety of antibiotics for pure Staphylococcal infections, and (2) examine the impact of ALBC use at primary surgery has on resistance patterns for patients undergoing first-time revision of primary hip and knee arthroplasty for indication of infection.

Materials and methods

Data from the National Joint Registry database for England and Wales were linked to microbiology data held by Public Health England to identify a consecutive series of 258 primary hip and knee arthroplasties performed between April 2003 and January 2014 that went on to have a revision for Staphylococcal deep periprosthetic infection. Multivariate binary logistic regression was used to study predictors of microorganism resistance to a range of antimicrobials.

Results

After adjusting for patient and surgical factors, multivariate analysis showed the use of gentamicin-loaded bone cement at the primary surgery was associated with a significant increase in the risk of Staphylococcal gentamicin resistance (odds ratio 8.341, 95% CI 2.297–30.292, p = 0.001) and methicillin resistance (odds ratio 3.870, 95% CI 1.319–11.359, p = 0.014) at revision for infection.

Conclusions

Clinicians must anticipate the possibility of antibiotic resistance to ALBC utilised at primary surgery.

Arciola CR, Campoccia D, Montanaro L (2002 Mar) Effects on antibiotic resistance of Staphylococcus epidermidis following adhesion to polymethylmethacrylate and to silicone surfaces. Biomater 23(6):1495–1502CrossRef

Arciola CR, Donati ME, Montanaro L (2001) Adhesion to a polymeric biomaterial affects the antibiotic resistance of Staphylococcus epidermidis. New Microbiol 24(1):63–68PubMed

Arizono T, Oga M, Sugioka Y (1992) Increased resistance of bacteria after adherence to polymethyl methacrylate. An in vitro study. Acta Orthop Scand 63(6):661–664PubMed

Bayston R, Milner RD (1982) The sustained release of antimicrobial drugs from bone cement. An appraisal of laboratory investigations and their significance. J Bone Joint Surg Br 64(4):460–464CrossRefPubMed

Chiu F-Y, Chen C-M, Lin C-FJ, Lo W-H (2002) Cefuroxime-impregnated cement in primary total knee arthroplasty: a prospective, randomized study of three hundred and forty knees. J Bone Joint Surg Am 84A(5):759–762CrossRef

Corona PS, Espinal L, Rodríguez-Pardo D, Pigrau C, Larrosa N, Flores X (2014) Antibiotic susceptibility in gram-positive chronic joint arthroplasty infections: increased aminoglycoside resistance rate in patients with prior aminoglycoside-impregnated cement spacer use. J Arthroplasty 29(8):1617–1621CrossRef

Dunbar MJ (2009) Antibiotic bone cements: their use in routine primary total joint arthroplasty is justified. Orthop 32(9):660–663CrossRef

Engesaeter LB, Espehaug B, Lie SA, Furnes O, Havelin LI (2006) Does cement increase the risk of infection in primary total hip arthroplasty? revision rates in 56,275 cemented and uncemented primary THAs followed for 0–16 years in the norwegian arthroplasty register. Acta Orthop 77(3):351–358CrossRefPubMed

Gristina AG, Shibata Y, Giridhar G, Kreger A, Myrvik QN (1994) The glycocalyx, biofilm, microbes, and resistant infection. Semin Arthrop 5(4):160–170

10.

Hansen EN, Adeli B, Kenyon R, Parvizi J (2014) Routine use of antibiotic laden bone cement for primary total knee arthroplasty: impact on infecting microbial patterns and resistance profiles. J Arthrop 29(6):1123–1127CrossRef

11.

Holleyman RJ, Baker P, Charlett A, Gould K, Deehan DJ (2016) Microorganisms responsible for periprosthetic knee infections in england and wales. Knee Surg Sports Traumatol Arthrosc 24(10):3080–3087CrossRefPubMed

12.

Holleyman RJ, Baker PN, Charlett A, Gould K, Deehan DJ (2016) Analysis of causative microorganism in 248 primary hip arthroplasties revised for infection: a study using the NJR dataset. Hip Int 26(1):82–89CrossRefPubMed

13.

Holleyman RJ, Deehan DJ, Charlett A, Gould K, Baker PN (2016) Does pre-operative sampling predict intra-operative cultures and antibiotic sensitivities in knee replacements revised for infection?: a study using the NJR dataset. Knee Surg Sports Traumatol Arthrosc 24(10):3056–3063CrossRefPubMed

14.

Hope PG, Kristinsson KG, Norman P, Elson RA (1989) Deep infection of cemented total hip arthroplasties caused by coagulase-negative staphylococci. J Bone Joint Surg Br 71(5):851–855CrossRefPubMed

15.

Kendall RW, Duncan CP, Beauchamp CP (1995) Bacterial growth on antibiotic-loaded acrylic cement. A prospective in vivo retrieval study. J Arthroplasty 10(6):817–822CrossRefPubMed

16.

Kendall RW, Duncan CP, Smith JA, Ngui-Yen JH (1996) Persistence of bacteria on antibiotic loaded acrylic depots. a reason for caution. Clin Orthop Relat Res. 329:273–280CrossRef

17.

Livermore DM (2000) Epidemiology of antibiotic resistance. Intensive Care Med 26(Suppl 1):S14–S21CrossRefPubMed

18.

Naylor PT, Myrvik QN, Gristina A (1990) Antibiotic resistance of biomaterial-adherent coagulase-negative and coagulase-positive staphylococci. Clin Orthop Relat Res 261:126–133

19.

Neut D, van de Belt H, Stokroos I, van Horn JR, van der Mei HC, Busscher HJ (2001) Biomaterial-associated infection of gentamicin-loaded PMMA beads in orthopaedic revision surgery. J Antimicrob Chemother 47(6):885–891CrossRef

20.

Parvizi J, Saleh KJ, Ragland PS, Pour AE, Mont MA.(2008) Efficacy of antibiotic-impregnated cement in total hip replacement. Acta Orthop 79(3):335–341CrossRef

21.

Picknell B, Mizen L, Sutherland R (1977) Antibacterial activity of antibiotics in acrylic bone cement. J Bone Joint Surg Br 59(3):302–307CrossRefPubMed

22.

Ramage G, Tunney MM, Patrick S, Gorman SP, Nixon JR (2003) Formation of Propionibacterium acnes biofilms on orthopaedic biomaterials and their susceptibility to antimicrobials. Biomaterials 24(19):3221–3227CrossRefPubMed

23.

Schurman DJ, Trindade C, Hirshman HP, Moser K, Kajiyama G, Stevens P (1978) Antibiotic-acrylic bone cement composites. Studies of gentamicin and Palacos. J Bone Joint Surg Am 60(7):978–984CrossRefPubMed

24.

Stefánsdóttir A, Johansson D, Knutson K, Lidgren L, Robertsson O (2009) Microbiology of the infected knee arthroplasty: report from the Swedish Knee Arthroplasty Register on 426 surgically revised cases. Scand J Infect Dis 41(11–12):831–840CrossRefPubMed

25.

Thomes B, Murray P, Bouchier-Hayes D (2002) Development of resistant strains of Staphylococcus epidermidis on gentamicin-loaded bone cement in vivo. J Bone Joint Surg Br 84(5):758–760CrossRefPubMed

Title: Staphylococcal resistance profiles in deep infection following primary hip and knee arthroplasty: a study using the NJR dataset
Authors: Richard J. Holleyman
David J. Deehan
Lucy Walker
Andre Charlett
Julie Samuel
Mark D. F. Shirley
Paul N. Baker
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Keywords: Gentamicin
Erythromycin
Antibiotic
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 9/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-019-03155-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Staphylococcal resistance profiles in deep infection following primary hip and knee arthroplasty: a study using the NJR dataset

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2019

Prevalence, development, and factors associated with cyst formation after meniscal repair with the all-inside suture device

Mid-term outcome (11–90 months) of the extensor retinaculum flap procedure for extensor carpi ulnaris tendon instability

Orthopedic trauma surgeon in Sierra Leone: how to keep one’s head over water

Surgical fixation of pilon injuries: a comparison of the anterolateral and posterolateral approach

Fifty top-cited classic papers in orthopaedic oncology: a bibliometric analysis

Kellgren–Lawrence scoring system underestimates cartilage damage when indicating TKA: preoperative radiograph versus intraoperative photograph