Mancheño-Losa, MikelLora-Tamayo, JaimeFernandez-Sampedro, MartaRodriguez-Pardo, DolorsMuñoz-Mahamud, ErnestoSoldevila, LauraPalou, MarionaBarbero, Jose MariaDel-Toro, Maria DoloresIribarren, Jose AntonioBenito, NatividadSobrino, BeatrizRico-Nieto, AliciaGuio-Carrion, LauraGomez, LuciaEscudero-Sanchez, RosaGarcia-Pais, Maria JoseJover-Saenz, AlfredoPraena, JuliaBaraia-Etxaburu, Josu MirenAuñon, AlvaroMuñez-Rubio, ElenaMurillo, Oscar2023-05-032023-05-032021-09-09Mancheño-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):542-549http://hdl.handle.net/10668/22320Background: 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.enProsthetic joint infectionInfected arthroplastyBiofilmForeign-boy infectionArthritisBacteriaArthroplastyProstheses and ImplantsBiofilmsFluoroquinolonesAnti-Bacterial Agentsresearch article35105460Restricted AccessInfeccionesPrótesis e ImplantesBiopelículasArtroplastiaArticulacionesAntibacterianos10.1016/j.jinf.2022.01.0211532-2742http://www.journalofinfection.com/article/S0163445322000214/pdf