Microbiological analysis of late infected hip arthroplasty in 62 cases

Department of Orthopedic Surgery, General Hospital of Chinese PLA, Beijing 100853, China.
Zhonghua yi xue za zhi 07/2011; 91(25):1762-5. DOI: 10.3760/cma.j.issn.0376-2491.2011.25.011
Source: PubMed


To review the type and number of pathogens and their antibiotic sensitivity in patients with late infected total joint replacement so as to offer guidance for the choice of antibiotics.
A retrospective analysis was conducted for 62 patients whose suspected specimens were obtained intra-operatively during a total hip arthroplasty since January 2002 to August 2010 at our department. Their demographic data, bacterial species and antibiotic sensitivity profiles were recorded.
Among 62 cases, the cultures were tested positive in 48 cases; the most common bacteria was Gram-positive bacteria (74%). And coagulase-negative staphylococci and Staphylococcus aureus accounted for 62.9% of all bacterial cultures. And the ratio of methicillin-resistant Staphylococcus was 41.18%.
The late infection of total hip arthroplasty is mainly caused by Gram-positive bacteria. Antibiotic treatment for late periprosthetic infection should be guided by the findings of drug susceptibility. Vancomycin may be used as a primary agent for the treatment of infected hip arthroplasty.

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    ABSTRACT: Our aim was to assess the bacterial findings in infected total hip arthroplasties (THAs) in Norway. We also wanted to investigate the relationship between causal bacteria and hematological findings. Revisions reported to the Norwegian Arthroplasty Register (NAR) due to infection after total hip arthroplasty during the period 1993 through September 2007 were identified. One single observer visited ten representative hospitals where clinical history, preoperative blood samples and the bacterial findings of intraoperative samples were collected. Bacterial growth in two or more samples was found in 278 revisions, and thus included. The following bacteria were identified: Coagulase-negative staphylococci (CoNS) (41%), Staphylococcus aureus (S. aureus) (19%), streptococci (11%), polymicrobial infections (10%), enterococci (9%), Gram-negative bacteria (6%) and others (4%). CoNS were the most common bacteria throughout the period but in the acute postoperative infections (< 3 weeks) S. aureus was the most frequent bacterial finding. We found no change in the distribution of the bacterial groups over time. S. aureus appears correlated with a higher C-reactive protein value (CRP) (mean 140 (95% Confidence interval (CI): 101-180)) than CoNS (mean 42 (CI: 31-53)). S. aureus also correlated with a higher erythrocyte sedimentation rate value (ESR) (mean 67 (CI: 55-79)) than CoNS (mean 47 (CI: 39-54)).
    The Open Orthopaedics Journal 09/2015; 9(1):445-449. DOI:10.2174/1874325001509010445

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