TY - JOUR
T1 - Prosthetic joint infection caused by gram-negative organisms
AU - Zmistowski, Benjamin
AU - Fedorka, Catherine J.
AU - Sheehan, Eoin
AU - Deirmengian, Gregory
AU - Austin, Matthew S.
AU - Parvizi, Javad
PY - 2011/9
Y1 - 2011/9
N2 - 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.
AB - 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.
KW - 2-Stage exchange
KW - Gram-negative PJI
KW - Irrigation and debridement
KW - Methicillin-resistant PJI
KW - Prosthetic joint infection
UR - http://www.scopus.com/inward/record.url?scp=84868300934&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2011.03.044
DO - 10.1016/j.arth.2011.03.044
M3 - Article
AN - SCOPUS:84868300934
VL - 26
SP - 104
EP - 108
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
SN - 0883-5403
IS - SUPPL. 6
ER -