Successful outcome for patients with streptococcal prosthetic joint infections - a retrospective population-based...

Streptococci cause approximately 10% of prosthetic joint infections (PJIs). The aim of this study was to identify the characteristics of patients with streptococcal PJIs and to describe the treatment and outcome of streptococcal PJIs in Skåne county between 2011 and 2015.

Patients with streptococcal PJIs with positive cultures or PCRs on samples from joint aspirate and/or periprosthetic tissue between 2011 and 2015 in Skåne county, were identified and medical records were studied.

Eighty-three PJI episodes treated at seven hospitals were identified. The median age was 70 years (IQR: 64-78) and there were more men (61%) than women. Hip joints were the most common site of isolation (54%). The most frequently isolated pathogens were beta-haemolytic streptococci of groups A, C and G (31%), group B (30%), and alpha-haemolytic streptococci (23%). Overall failure rate was 11% (n = 9), and lack of comorbidity was significantly associated with a favourable outcome. The most common treatment strategy was debridement, antibiotic treatment and implant retention (DAIR) (n = 64; 77%) and the initial success rate using this strategy was 84% (n = 53).

This study indicates an acceptable success rate for the patients treated with DAIR strategy, and a high overall success rate for episodes suffering streptococcal PJIs.