RT Journal Article
T1 Acute haematogenous prosthetic joint infection: prospective evaluation of medical and surgical management
A1 Rodríguez, D
A1 Pigrau, C
A1 Euba, G
A1 Cobo, J
A1 García-Lechuz, J
A1 Palomino, J
A1 Riera, M
A1 del Toro, M.D.
A1 Granados, A
A1 Ariza, X
K1 Acute infection
K1 Antibiotic therapy
K1 Haematogenous infection
K1 Prosthetic joint infections
K1 Treatment
AB The optimum treatment for prosthetic joint infections has not been clearly defined. We report our experience of the management of acute haematogenous prosthetic joint infection (AHPJI) in patients during a 3-year prospective study in nine Spanish hospitals. Fifty patients, of whom 30 (60%) were female, with a median age of 76 years, were diagnosed with AHPJI. The median infection-free period following joint replacement was 4.9 years. Symptoms were acute in all cases. A distant previous infection and/or bacteraemia were identified in 48%. The aetiology was as follows: Staphylococcus aureus, 19; Streptococcus spp., 14; Gram-negative bacilli, 12; anaerobes, two; and mixed infections, three. Thirty-four (68%) patients were treated with a conservative surgical approach (CSA) with implant retention, and 16 had prosthesis removal. At 2-year follow-up, 24 (48%) were cured, seven (14%) had relapsed, seven (14%) had died, five (10%) had persistent infection, five had re-infection, and two had an unknown evolution. Overall, the treatment failure rates were 57.8% in staphylococcal infections and 14.3% in streptococcal infections. There were no failures in patients with Gram-negative bacillary. By multivariate analysis, CSA was the only factor independently associated with treatment failure (OR 11.6; 95% CI 1.29-104.8). We were unable to identify any factors predicting treatment failure in CSA patients, although a Gram-negative bacillary aetiology was a protective factor. These data suggest that although conservative surgery was the only factor independently associated with treatment failure, it could be the first therapeutic choice for the management of Gram-negative bacillary and streptococcal AHPJI, and for some cases with acute S. aureus infections.
PB European Society of Clinical Microbiology and Infectious Diseases
SN 1198-743X
YR 2009
FD 2009-12-29
LK http://hdl.handle.net/10668/1786
UL http://hdl.handle.net/10668/1786
LA en
NO Rodríguez D, Pigrau C, Euba G, Cobo J, García-Lechuz J, Palomino J, et al. Acute haematogenous prosthetic joint infection: prospective evaluation of medical and surgical management. Clin Microbiol Infect. 2010 Dec;16(12):1789-95
NO This study was presented, in part, as a poster (K-1055) atthe 47th Annual Meeting of the Interscience Conference onAntimicrobial Agents and Chemotherapy/Infectious DiseasesSociety of America, Chicago, 17–20 September 2007. Journal Article; Research Support, Non-U.S. Gov't;
DS RISalud
RD Aug 8, 2025