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Vancomycin-resistant Enterococcus infected total knee arthroplasty
1Department of Orthopaedic Surgery, University of California, San Francisco 94143-0728, USA. riesm@orthosurg.ucsf.edu
The Journal of Arthroplasty
|September 8, 2001
Summary
Vancomycin resistance in Enterococcus can arise from treating methicillin-resistant Staphylococcus aureus. Two patients developed nosocomial vancomycin-resistant Enterococcus infections after knee surgery, requiring extensive treatment.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Vancomycin is crucial for treating infections caused by methicillin-resistant Staphylococcus aureus (MRSA).
- Widespread vancomycin use has led to the emergence of vancomycin-resistant Enterococcus (VRE).
- Enterococcal infections pose significant challenges, particularly in hospital settings.
Observation:
- Two patients developed postoperative infections following total knee arthroplasty.
- These infections were identified as nosocomial, caused by vancomycin-resistant Enterococcus.
- Both patients required multiple surgical interventions for infection control.
Findings:
- Serial open débridements were employed to manage the VRE infections.
- One patient achieved successful knee fusion.
- The other patient's knee was managed with resection arthroplasty.
Implications:
- Highlights the risk of VRE development secondary to vancomycin use for MRSA.
- Underscores the challenges of treating nosocomial VRE infections in orthopedic surgery.
- Demonstrates the need for effective management strategies for VRE in prosthetic joint infections.