Occurrence of Rare Pathogens at the Site of Periprosthetic Hip and Knee Joint Infections: A Retrospective,...

Area of Science:

• Orthopedics
• Infectious Diseases
• Clinical Microbiology

Background:

• Periprosthetic joint infections (PJIs) pose a significant challenge.
• In-depth data on rare pathogens in hip and knee PJIs and their antibiotic resistance is limited.

Purpose of the Study:

• To determine the frequency and clinical relevance of rare pathogens in hip and knee PJIs.
• To analyze the antibiotic resistance profiles of these rare microorganisms.
• To evaluate patient outcomes and emphasize interdisciplinary collaboration.

Main Methods:

• Retrospective analysis of 165 hip and knee PJIs from 2016-2020.
• Identification of causative microorganisms, focusing on rare pathogens.
• Assessment of antibiotic susceptibility testing results.
• Review of patient follow-up data.

Main Results:

• Rare microorganisms accounted for 9.7% of PJIs.
• Identified rare pathogens include *Veillonella* sp., *Pasteurella* sp., *Pantoea* sp., *Citrobacter koseri*, *Serratia marcescens*, *Parvimonas micra*, *Clostridium difficile*, *Finegoldia magna*, *Morganella morganii*, and yeasts.
• No resistance was observed against piperacillin/tazobactam, carbapenemes, fluoroquinolones, or gentamicin.
• Some isolates showed resistance to ampicillin, ampicillin/sulbactam, and cefuroxime.

Conclusions:

• Rare pathogens are an important, though infrequent, cause of hip and knee PJIs.
• Understanding specific resistance patterns is crucial for effective treatment.
• Close collaboration between orthopedic surgeons and clinical microbiologists is vital for optimal patient management.