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Updated: May 8, 2026
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
[The microbiology and antimicrobial susceptibility of the infected knee arthroplasty]
Hui-ming Peng1, Xi-sheng Weng, Ji-liang Zhai
1Department of Orthopedics, Peking Union Medical Collage Hospital, Peking Union Medical Collage, Chinese Academy of Medical Science, Beijing 100730, China.
Objectives:
To describe the microbiology, antimicrobial susceptibility of patients proven prosthetic joint infection (PJI) after primary total knee arthroplasty (TKA)and to provide reference for the diagnosis and treatment of this complication.
Methods:
The medical data of the patients with infected knee arthroplasty, who were managed with revision surgery between January 1995 to December 2011 were reviewed. Twenty-nine cases were identified and majority of the patients were female (23/29). Diagnosis of PJI after primary TKA was between 1 week and 10 years (average 24.3 months). The microbiology and antimicrobial susceptibility were analyzed.
Result:
The overall positive rate of cultures was 65.5% (19/29). The most common organisms identified were Coagulase-negative Staphylococcus (CNS) (7/19) and Staphylococcus Aureus (SA) (5/19). Rare pathogens of Mycobacterium (2/19) and fungi (1/19) were also identified. Vancomycin was the most effective antibiotics with overall sensitivity rates of 100%.Resistant and rare pathogens were all in type IV infection.
Conclusions:
Gram-positive bacterias are the main pathogen, resistant and rare pathogens should be payed attention to. Antibiotic treatment for infected TKA should be based on the results of drug susceptibility. Vancomycin allows infected knee arthroplasties before the result.
Insights
Prosthetic joint infections (PJI) after total knee arthroplasty (TKA) are often caused by Gram-positive bacteria. Vancomycin shows high effectiveness, guiding treatment for resistant and rare pathogens in TKA infections.
Area of Science:
- Orthopedic surgery
- Infectious diseases
- Microbiology
Context:
- Prosthetic joint infection (PJI) is a serious complication following total knee arthroplasty (TKA).
- Understanding the specific microbial landscape and antibiotic sensitivities is crucial for effective management.
- This study reviews cases of PJI after primary TKA managed with revision surgery.
Purpose:
- To characterize the microbiology and antimicrobial susceptibility patterns of PJI after TKA.
- To provide data to guide the diagnosis and treatment of TKA-associated PJI.
- To identify common and rare pathogens involved in infected knee arthroplasty.
Summary:
- A review of 29 patients with PJI after TKA revealed a 65.5% culture-positive rate.
- Coagulase-negative Staphylococcus and Staphylococcus Aureus were the most frequent pathogens.
- Rare organisms like Mycobacterium and fungi were also identified; Vancomycin demonstrated 100% sensitivity.
Impact:
- Highlights the prevalence of Gram-positive bacteria in TKA PJI.
- Emphasizes the importance of culture-guided antibiotic therapy.
- Suggests Vancomycin as an effective initial treatment option for suspected infected knee arthroplasty prior to susceptibility results.
