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Periprosthetic Joint Infections as a Consequence of Bacteremia

Meeri Honkanen1, Esa Jämsen2, Matti Karppelin1

  • 1Department of Internal Medicine, Tampere University Hospital, Tampere University, Tampere, Finland.

Open Forum Infectious Diseases
|June 20, 2019
PubMed
Abstract

Insights

Periprosthetic joint infection (PJI) risk after bacteremia depends on the bacteria and surgery timing. Patient factors did not significantly influence PJI development during bacteremia.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Epidemiology

Background:

  • Periprosthetic joint infection (PJI) risk during bacteremia is largely unknown, except for Staphylococcus aureus.
  • This study aimed to assess PJI risk during bacteremia and identify associated risk factors.

Purpose of the Study:

  • To investigate the incidence of periprosthetic joint infection (PJI) following bacteremia in patients with joint replacements.
  • To identify specific pathogens and patient characteristics that increase PJI risk during bacteremia.

Main Methods:

  • Retrospective analysis of 14,378 primary knee/hip replacement patients from 2002-2013.
  • Identification and confirmation of bacteremia and PJI cases through blood cultures and patient records.
  • Univariate logistic regression used to examine potential risk factors for PJI in bacteremic patients.

Main Results:

  • 542 patients (3.8%) experienced bacteremia; 7% (47/643) developed PJI.
  • Staphylococcus aureus and beta-hemolytic streptococci bacteremia had the highest PJI rates (21%).
  • Multiple bacteremic episodes (OR 2.29) and bacteremia within one year of surgery increased PJI risk; chronic comorbidities did not.

Conclusions:

  • PJI development during bacteremia is influenced by the causative pathogen and timing relative to joint replacement surgery.
  • No significant patient-related risk factors were identified for PJI development during bacteremia.
Keywords:
Staphylococcus aureusbacteremiaprosthetic joint infectionrisk factorsstreptococci

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