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Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
Mycobacterium abscessus Periprosthetic joint infection following bilateral Total Knee arthroplasty
Rajesh Malhotra1, Kiran Bala2, Deepak Gautam1
1Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
Periprosthetic joint infection (PJI) can be protracted, incapacitating, needing multiple interventions and could even lead to mortality. Early post-operative PJI has been ascribed to peri-operative introduction of highly virulent bacteria, while delayed post-operative to low-virulence bacteria. Non-tuberculous mycobacteria (NTM) do not figure in the usual list of etiological agents. We report a case of difficult diagnosis of bilateral PJI caused by Mycobacterium abscessus, following bilateral total knee arthroplasty in an elderly male, but treated successfully despite prolonged infection. M. abscessus complex comprises a group of rapidly growing, multidrug-resistant NTM, capable of forming biofilms on prostheses, responsible for wide spectrum of hospital acquired infections. M. abscessus as a cause of PJI is not reported widely. There are a few cases described in literature worldwide. There are no policy guidelines available for treating such cases. High clinical suspicion, with a concerted effort to grow and identify the causal pathogen is important. Standard anti-tubercular therapy is not recommended for treatment due to inherent resistance. Complete excision of infected tissues and removal of prosthesis along with prolonged combination antimicrobial regimen is the treatment of choice.
Insights
Diagnosing and treating periprosthetic joint infection (PJI) caused by Mycobacterium abscessus is challenging. This case highlights successful management of a rare bilateral knee PJI due to this multidrug-resistant bacterium.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Periprosthetic joint infection (PJI) is a severe complication of joint replacement surgery.
- Non-tuberculous mycobacteria (NTM), particularly Mycobacterium abscessus, are rarely implicated in PJI.
- Mycobacterium abscessus is a multidrug-resistant pathogen known for biofilm formation on medical implants.
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