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Published on: December 3, 2017
Multidrug-Resistant Organisms in the Setting of Periprosthetic Joint Infection-Diagnosis, Prevention, and Treatment
Matthew P Siljander1, Ali H Sobh1, Kevin C Baker2
1Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, Michigan.
Background:
Periprosthetic joint infection (PJI) is a rare yet challenging problem in total hip and knee arthroplasties. The management of PJI remains difficult primarily due to the evolution of resistance by the infecting organisms.
Methods:
This review profiles acquired mechanisms of bacterial resistance and summarizes established and emerging techniques in PJI diagnosis, prevention, and treatment.
Results:
New techniques in PJI diagnosis and prevention continue to be explored. Antibiotics combined with 1 or 2-stage revision are associated with the higher success rates and remain the mainstay of treatment.
Conclusion:
With higher prevalence of antibiotic-resistant organisms, novel antibiotic implant and wound care materials, improved methods for organism identification, and well-defined organism-specific treatment algorithms are needed to optimize outcomes of PJI.
Insights
Periprosthetic joint infection (PJI) management is challenging due to antibiotic resistance. Effective PJI treatment requires novel approaches and organism-specific algorithms for better patient outcomes.
Area of Science:
- Orthopedic surgery
- Infectious diseases
- Microbiology
Background:
- Periprosthetic joint infection (PJI) is a rare but serious complication following hip and knee replacements.
- Managing PJI is difficult due to increasing bacterial resistance to antibiotics.
Purpose of the Study:
- To review acquired mechanisms of bacterial resistance in PJI.
- To summarize current and emerging diagnostic, preventive, and treatment strategies for PJI.
Main Methods:
- Literature review of acquired resistance mechanisms.
- Synthesis of established and novel techniques for PJI management.
Main Results:
- Antibiotic resistance is a significant challenge in PJI.
- One-stage or two-stage revision surgery combined with antibiotics shows high success rates.
- New diagnostic and preventive methods for PJI are under development.
Conclusions:
- Optimizing PJI outcomes necessitates addressing antibiotic resistance.
- Novel materials for antibiotic implants and wound care are needed.
- Improved organism identification and organism-specific treatment algorithms are crucial for PJI management.
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