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Difficult-to-treat pathogens significantly reduce infection resolution in periprosthetic joint infections

Matthias D Wimmer1, Gunnar T R Hischebeth2, Thomas M Randau1

  • 1Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.

Diagnostic Microbiology and Infectious Disease
|July 27, 2020
PubMed

Insights

Periprosthetic joint infection (PJI) from difficult-to-treat pathogens leads to more revision surgeries and lower infection resolution rates compared to other PJI cases. This highlights challenges in treating complex joint infections.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Microbiology

Background:

  • Periprosthetic joint infection (PJI) is a significant complication following joint replacement surgery.
  • Certain pathogens present unique challenges in diagnosis and treatment, potentially impacting patient outcomes.

Purpose of the Study:

  • To compare the outcomes of PJI caused by difficult-to-treat (DTT) pathogens versus non-DTT pathogens.
  • To evaluate the impact of DTT pathogens on infection resolution and the need for revision surgery.

Main Methods:

  • Retrospective analysis of clinical data from 77 patients with confirmed PJI undergoing 2-stage exchange arthroplasty.
  • Patients were categorized into DTT and non-DTT PJI groups.
  • Primary outcome: definitive infection resolution at 2 years post-treatment.

Main Results:

  • Definitive infection resolution was achieved in 68.9% of the DTT group versus 87.5% in the non-DTT group (P < 0.05).
  • Patients with DTT PJI required significantly more revision operations (4.72 ± 3.03) compared to non-DTT PJI (2.41 ± 3.02) (P < 0.05).

Conclusions:

  • PJI caused by difficult-to-treat bacteria is associated with poorer clinical outcomes.
  • Higher rates of revision surgery and lower rates of definitive infection resolution are observed in DTT PJI cases.
Keywords:
ArthroplastyDTTDifficult-to-treatInfectionPeriprosthetic joint infectionRevision

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