Trends in microbiological profiles and antibiotic resistance in periprosthetic joint infections

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Microbiology
• Pharmacology

Background:

• Periprosthetic joint infection (PJI) is a significant complication following joint replacement surgery.
• Understanding trends in causative microorganisms and their antibiotic resistance is crucial for effective management.
• Previous studies have indicated shifts in microbial patterns and resistance, necessitating ongoing surveillance.

Purpose of the Study:

• To analyze temporal trends in patient demographics, microbial distribution, and antibiotic resistance patterns in PJI.
• To identify changes in the prevalence of specific pathogens and their susceptibility to common antibiotics over a decade.
• To provide data that can inform updated clinical guidelines for PJI treatment and prevention.

Main Methods:

• A retrospective study was conducted on 231 patients diagnosed with PJI between January 2006 and December 2015.
• Data on patient demographics, isolated microorganisms, and antibiotic susceptibility were collected.
• Statistical analysis, including the linear-by-linear chi-squared test, was employed to assess trends over two distinct periods (2006-2010 and 2011-2015).

Main Results:

• Gram-positive cocci were the predominant pathogens (63.9%), with coagulase-negative Staphylococcus (CoNS) being the most frequent (38.1%).
• A significant increase in methicillin-resistant CoNS (MRCoNS) was observed (39.0% to 61.8%).
• Resistance to levofloxacin in CoNS and S. aureus, and resistance to methicillin in S. aureus, also significantly increased, while penicillin resistance decreased for both CoNS and S. aureus.

Conclusions:

• The study identified significant shifts in the microbial landscape and antibiotic resistance profiles of pathogens causing PJI.
• These evolving resistance patterns may complicate empirical and targeted treatment strategies for PJI.
• The findings offer valuable insights for developing and refining prevention and empirical treatment protocols for PJI, particularly in the Chinese context.