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Orthopedic Implant-Associated Infection by Multidrug Resistant Enterobacteriaceae

Bernadette G Pfang1, Joaquín García-Cañete2, Julia García-Lasheras3

  • 1Department of Internal Medicine, Hospital Universitario Fundación Jiménez Díaz. IIS-Fundación Jiménez Díaz, UAM, 28040 Madrid, Spain. bernadettepfang@gmail.com.

Journal of Clinical Medicine
|February 13, 2019
PubMed
Abstract

Insights

Orthopedic implant infections from multidrug-resistant Enterobacteriaceae are challenging. Implant removal significantly improves infection control, though retention may be viable in select cases. Further research is needed for debridement and antibiotic strategies.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Microbiology

Background:

  • Orthopedic implant-associated infections caused by multidrug-resistant Enterobacteriaceae present a growing clinical challenge.
  • Increasing incidence and treatment difficulties necessitate effective management strategies.

Purpose of the Study:

  • To evaluate the outcomes of treating multidrug-resistant Enterobacteriaceae orthopedic implant-associated infections.
  • To determine the association between implant removal and infection control.

Main Methods:

  • Retrospective observational study of 25 patients diagnosed with multidrug-resistant Enterobacteriaceae orthopedic implant-associated infections.
  • Review of clinical records and data analysis using IBM® SPSS® version 22.

Main Results:

  • Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae were the most common pathogens.
  • Implant removal was performed in 64% of patients, achieving 100% infection control.
  • Implant retention resulted in a 33% infection control rate, with a strong association between removal and control (p = 0.001).

Conclusions:

  • Implant removal is strongly associated with successful infection control in multidrug-resistant Enterobacteriaceae orthopedic implant infections.
  • Patient age and comorbidities may contraindicate hardware extraction.
  • Future research should explore debridement, antibiotic therapy, and implant retention as a first-line strategy for specific patient populations.
Keywords:
orthopedic implant-associated infection, bone and joint infection, prosthetic joint infection, multidrug resistant Enterobacteriaceae, multidrug resistant Gram-negative bacilli

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