RT Journal Article
T1 Prognosis of unexpected positive intraoperative cultures in arthroplasty revision: A large multicenter cohort
A1 Mancheño-Losa, Mikel
A1 Lora-Tamayo, Jaime
A1 Fernandez-Sampedro, Marta
A1 Rodriguez-Pardo, Dolors
A1 Muñoz-Mahamud, Ernesto
A1 Soldevila, Laura
A1 Palou, Mariona
A1 Barbero, Jose Maria
A1 Del-Toro, Maria Dolores
A1 Iribarren, Jose Antonio
A1 Benito, Natividad
A1 Sobrino, Beatriz
A1 Rico-Nieto, Alicia
A1 Guio-Carrion, Laura
A1 Gomez, Lucia
A1 Escudero-Sanchez, Rosa
A1 Garcia-Pais, Maria Jose
A1 Jover-Saenz, Alfredo
A1 Praena, Julia
A1 Baraia-Etxaburu, Josu Miren
A1 Auñon, Alvaro
A1 Muñez-Rubio, Elena
A1 Murillo, Oscar
K1 Prosthetic joint infection
K1 Infected arthroplasty
K1 Biofilm
K1 Foreign-boy infection
K1 Arthritis
AB Background: The positive-intraoperative-cultures-type prosthetic joint infection (PIOC-PJI) is considered when surgical cultures yield microorganisms in presumed aseptic arthroplasty revisions. Herein we assess the risk factors for failure in the largest cohort of PIOC-PJI patients reported to date.Methods: A retrospective, observational, multicenter study was performed during 2007-2017. Surgeries leading to diagnose PIOC-PJI included only one-stage procedures with either complete or partial prosthesis revision. Failure was defined as recurrence caused by the same microorganism.Results: 203 cases were included (age 72 years, 52% females). Coagulase-negative staphylococci (n = 125, 62%) was the main etiology, but some episodes were caused by virulent bacteria (n = 51, 25%). Prosthesis complete and partial revision was performed in 93 (46%) and 110 (54%) cases, respectively. After a median of 3.4 years, failure occurred in 17 episodes (8.4%, 95%CI 5.3-13.1). Partial revision was an independent predictor of failure (HR 3.63; 95%CI 1.03-12.8), adjusted for gram-negative bacilli (GNB) infection (HR 2.68; 95%CI 0.91-7.89) and chronic renal impairment (HR 2.40; 95%CI 0.90-6.44). Treatment with biofilm-active antibiotics (rifampin/fluoroquinolones) had a favorable impact on infections caused by staphylococci and GNB.Conclusion: Overall prognosis of PIOC-PJI is good, but close follow-up is required in cases of partial revision and in infections caused by GNB.
PB Elsevier
YR 2021
FD 2021-09-09
LK http://hdl.handle.net/10668/22320
UL http://hdl.handle.net/10668/22320
LA en
NO Mancheño-Losa M, Lora-Tamayo J, Fernández-Sampedro M, Rodríguez-Pardo D, Muñoz-Mahamud E, Soldevila L, et al. Prognosis of unexpected positive intraoperative cultures in arthroplasty revision: A large multicenter cohort. J Infect. 2021 Nov;83(5):542-549
DS RISalud
RD Apr 6, 2025