Microbiology Alloplastic Total Joint Infections: A 20-Year Retrospective Study

Area of Science:

• Oral and Maxillofacial Surgery
• Infectious Diseases
• Biomaterials Science

Background:

• Prosthetic joint infection (PJI) is a rare but serious complication following temporomandibular joint replacement (TJR).
• Understanding the causative organisms and their antibiotic resistance patterns is crucial for effective management of TJR PJI.

Purpose of the Study:

• To evaluate prosthetic joint infections (PJIs) after temporomandibular joint replacement (TJR) over a 20-year period.
• To identify common microorganisms, antibiotic resistance patterns, and intraoperative protocols associated with TJR PJIs.

Main Methods:

• Retrospective review of patients undergoing TJR from January 1995 to 2015.
• Inclusion criteria: adults with alloplastic TJR and confirmed PJI at explantation.
• Data collected included microbial cultures, antibiotic sensitivities, and surgical details.

Main Results:

• Fifteen joints from eleven patients were analyzed, with an average in vivo duration of 232 months.
• Early, intermediate, and late PJI were identified in 6%, 46%, and 33% of cases, respectively.
• Staphylococcus aureus (53%) was the predominant organism, followed by Propionibacterium acnes (33%). Penicillin showed 46% resistance.

Conclusions:

• Staphylococcus aureus is the most frequent pathogen in TJR PJI, consistent with existing literature.
• Propionibacterium acnes is also prevalent and may contribute to PJI and biofilm formation.
• Vancomycin and first-generation cephalosporins are suggested as potential perioperative antibiotic choices.