Prosthetic joint infection caused by gram-negative organisms

Benjamin Zmistowski, Catherine J. Fedorka, Eoin Sheehan, Gregory Deirmengian, Matthew S. Austin, Javad Parvizi

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149 Scopus citations


Traditionally, periprosthetic joint infections (PJIs) due to gram-negative organisms are considered more difficult to manage; however, little literature exists with regard to outcome of PJI caused by gram-negative organisms. We identified 277 patients with 282 culture-positive PJI receiving surgical treatment. Thirty-one joints were treated for gram-negative PJI. The gramnegative group was then compared with the gram-positive and polymicrobial PJI. A single debridement and retention of prosthesis were successful in 70% (7/10) of isolated gram negative compared with 33.3% (13/39) of methicillin-sensitive gram positive, 48.9% (23/47) of methicillin-resistant gram positive, and 57.1% (4/7) of polymicrobial. Of those patients undergoing a planned 2-stage exchange, a successful reimplantation was performed in 52% (12/23) of gram-negative, 51% (52/103) of methicillin-resistant gram-positive, 69% (65/94) of methicillin-sensitive gram-positive, and 0% (0/8) of polymicrobial PJI cases. These results indicate that PJI due to gram-negative pathogens, although less common, is difficult to treat and is associated with limited success.

Original languageEnglish
Pages (from-to)104-108
Number of pages5
JournalJournal of Arthroplasty
Issue numberSUPPL. 6
StatePublished - Sep 2011


  • 2-Stage exchange
  • Gram-negative PJI
  • Irrigation and debridement
  • Methicillin-resistant PJI
  • Prosthetic joint infection


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