Infection following orthopaedic implants and bone surgery

Area of Science:

• Orthopaedic Surgery
• Infectious Diseases
• Microbiology

Background:

• Postoperative infections pose a significant risk in orthopaedic surgery.
• Identifying causative agents is crucial for effective treatment and management.
• The role of anaerobic bacteria in these infections requires further elucidation.

Purpose of the Study:

• To investigate the prevalence and role of both aerobic and anaerobic bacteria in early and late postoperative orthopaedic infections.
• To identify common bacterial pathogens, including anaerobes, in orthopaedic implant and bone infections.
• To determine if anaerobic bacteria are associated with specific types of fixation devices or infection timing.

Main Methods:

• Prospective investigation of 47 patients with early or late postoperative orthopaedic infections.
• Collection and microbiological analysis of 88 bacterial isolates (64 aerobic, 24 anaerobic).
• Correlation of bacterial findings with infection onset (early vs. late) and presence of internal fixation devices.

Main Results:

• Pseudomonas aeruginosa and Staphylococcus epidermidis were the most frequent aerobic isolates.
• Anaerobic bacteria were isolated from 34% of patients, with a higher prevalence (50%) in late-onset infections compared to early-onset infections (10.5%).
• Six patients (12.8%) experienced infections solely due to anaerobic organisms, all of whom had retained extramedullary internal fixation devices.

Conclusions:

• Anaerobic microorganisms play a notable role in the pathogenesis of late-onset postoperative orthopaedic infections.
• The presence of an extramedullary internal fixation device may increase the risk of anaerobic infection.
• Further research into anaerobic infections in orthopaedic surgery is warranted, especially concerning device-related complications.