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Outcome of orthopedic implant infections due to different staphylococci

Dorota Teterycz1, Tristan Ferry, Daniel Lew

  • 1Orthopedic Surgery Service, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|August 24, 2010
PubMed
Abstract

Insights

Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) infections lead to worse outcomes than coagulase-negative staphylococci (CoNS) in orthopedic implant infections. CoNS infections show the best cure rates, while MRSA infections have the poorest outcomes.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Microbiology

Background:

  • Orthopedic implant infections are a significant clinical challenge.
  • Comparisons between different staphylococcal species in these infections are limited.
  • This study focuses on infections caused by methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), and coagulase-negative staphylococci (CoNS).

Purpose of the Study:

  • To compare the outcomes of orthopedic implant infections caused by MSSA, MRSA, and CoNS.
  • To identify factors influencing cure rates in these infections.

Main Methods:

  • Retrospective study conducted at Geneva University Hospitals from January 1996 to June 2008.
  • Involved analysis of 44 MRSA, 58 MSSA, and 61 CoNS orthopedic implant infections.
  • Multivariate analysis was used to determine factors associated with cure.

Main Results:

  • Overall cure rates were 57% for MRSA, 72% for MSSA, and 82% for CoNS.
  • In arthroplasty infections specifically, cure rates were 39% (MRSA), 60% (MSSA), and 77% (CoNS).
  • MRSA infections and arthroplasty were inversely associated with cure, while CoNS infections and new implant insertion were associated with higher cure rates. MRSA patients experienced more sequelae.

Conclusions:

  • Staphylococcus aureus, particularly MRSA, is more virulent than CoNS in orthopedic implant infections.
  • MRSA infections are associated with the worst outcomes, while CoNS infections have the most favorable outcomes.
  • CoNS infections and new implant insertion correlate with better treatment success.

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