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01-12-2020 | Wound Debridement | Research article

Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention

Authors: Bruno Alves Rudelli, Pedro Nogueira Giglio, Vladimir Cordeiro de Carvalho, José Ricardo Pécora, Henrique Melo Campos Gurgel, Ricardo Gomes Gobbi, José Riccardo Negreiros Vicente, Ana Lucia Lei Munhoz Lima, Camilo Partezani Helito

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

Abstract

Background

Evaluate the effect of bacteria drug resistance profile on the success rates of debridement, antibiotics and implant retention.

Methods

All early acute periprosthetic infections in hip and knee arthroplasties treated with DAIR at our institution over the period from 2011 to 2015 were retrospectively analyzed. The success rate was evaluated according to the type of organism identified in culture: multidrug-sensitive (MSB), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negative bacteria (MRB) and according to other risk factors for treatment failure. The data were analyzed using univariate and multivariate statistics.

Results

Fifty-seven patients were analyzed; there were 37 in the multidrug-sensitive bacteria (MSB) group, 11 in the methicillin-resistant Staphylococcus aureus (MRSA) group and 9 in the other multidrug-resistant Gram-negative bacteria (MRB) group. There was a statistically significant difference (p < 0.05) in the treatment failure rate among the three groups: 8.3% for the MSB group, 18.2% for the MRSA group and 55.6% for the MRB group (p = 0.005). Among the other risk factors for treatment failure, the presence of inflammatory arthritis presented a failure rate of 45.1 (p < 0.05).

Conclusion

DAIR showed a good success rate in cases of early acute infection by multidrug-sensitive bacteria. In the presence of infection by multidrug-resistant bacteria or association with rheumatic diseases the treatment failure rate was higher and other surgical options should be considered in this specific population. The MRSA group showed intermediate results between MSB and MRB and should be carefully evaluated.

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Title: Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention
Authors: Bruno Alves Rudelli
Pedro Nogueira Giglio
Vladimir Cordeiro de Carvalho
José Ricardo Pécora
Henrique Melo Campos Gurgel
Ricardo Gomes Gobbi
José Riccardo Negreiros Vicente
Ana Lucia Lei Munhoz Lima
Camilo Partezani Helito
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Wound Debridement
Antibiotic
Joint Infection
Hip-TEP
Hip-TEP
Published in: BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-020-03570-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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