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Group B streptococcus in prosthetic hip and knee joint-associated infections

P Sendi1, B Christensson, I Uçkay

  • 1Unit of Infectious Diseases, Basel University Medical Clinic Liestal, Liestal, Switzerland. sendi-pa@magnet.ch

The Journal of Hospital Infection
|July 19, 2011
PubMed

Insights

Group B Streptococcus (GBS) periprosthetic joint infections (PJIs) are increasing in adults. Effective treatment, often involving implant removal, can lead to cure and preserved mobility.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • Invasive group B Streptococcus (GBS) infections are rising in non-pregnant adults.
  • Knowledge regarding GBS periprosthetic joint infections (PJIs) is limited.
  • This study investigates GBS PJI clinical presentation, treatment, and outcomes.

Purpose of the Study:

  • To analyze the clinical features of GBS PJI.
  • To evaluate treatment strategies for GBS PJI.
  • To determine factors influencing GBS PJI outcomes.

Main Methods:

  • Retrospective analysis of 36 GBS PJI cases from 10 centers.
  • Follow-up data for at least 2 years on 34 episodes.
  • Assessment of clinical presentation, comorbidities, surgical interventions, antimicrobial therapy, and outcomes.

Main Results:

  • Most GBS PJIs (75%) occurred over 3 months post-implantation.
  • High rates of comorbidities (91%), acute symptoms (69%), and soft tissue damage (83%) were observed.
  • Implant removal was necessary in 56% of cases; debridement with implant retention was successful in specific scenarios (short symptom duration, stable prosthesis, minor tissue damage).
  • High cure rates (94%) and functional mobility preservation (82%) were achieved.
  • Adherence to a published surgical algorithm correlated with favorable outcomes (P = 0.049).

Conclusions:

  • GBS PJI presents with significant comorbidities and tissue damage.
  • Treatment success, particularly for debridement with implant retention, depends on early intervention and specific clinical factors.
  • Surgical management following established guidelines improves outcomes in GBS PJI.

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