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Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
Microbiological pathogen analysis in native versus periprosthetic joint infections: a retrospective study
Sebastian Linke1, Alexander Thürmer2, Kevin Bienger3
1University Centre of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus Dresden, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany. Sebastian.Linke@uniklinikum-dresden.de.
Background:
The presence or absence of an implant has a major impact on the type of joint infection therapy. Thus, the aim of this study was the examination of potential differences in the spectrum of pathogens in patients with periprosthetic joint infections (PJI) as compared to patients with native joint infections (NJI).
Methods:
In this retrospective study, we evaluated culture-positive synovial fluid samples of 192 consecutive patients obtained from January 2018 to January 2020 in a tertiary care university hospital. For metrically distributed parameters, Mann-Whitney U was used for comparison between groups. In case of nominal data, crosstabs and Chi-squared tests were implemented.
Results:
Overall, 132 patients suffered from periprosthetic joint infections and 60 patients had infections of native joints. The most commonly isolated bacteria were coagulase-negative Staphylococci (CNS, 28%), followed by Staphylococcus aureus (S. aureus, 26.7%), and other bacteria, such as Streptococci (26.3%). We observed a significant dependence between the types of bacteria and the presence of a joint replacement (p < 0.05). Accordingly, detections of CNS occurred 2.5-fold more frequently in prosthetic as compared to native joint infections (33.9% vs. 13.4% p < 0.05). In contrast, S. aureus was observed 3.2-fold more often in NJIs as compared to PJIs (52.2% vs. 16.4%, p < 0.05).
Conclusion:
The pathogen spectra of periprosthetic and native joint infections differ considerably. However, CNS and S. aureus are the predominant microorganisms in both, PJIs and NJIs, which may guide antimicrobial therapy until microbiologic specification of the causative pathogen.
Insights
Periprosthetic joint infections (PJIs) and native joint infections (NJIs) show distinct pathogen profiles. Coagulase-negative Staphylococci are more common in PJIs, while Staphylococcus aureus dominates NJIs, guiding initial antimicrobial treatment.
Area of Science:
- Orthopedics
- Infectious Diseases
- Microbiology
Background:
- Joint infection therapy differs significantly based on the presence or absence of an implant.
- Understanding pathogen spectrum differences is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate and compare the spectrum of causative pathogens in periprosthetic joint infections (PJIs) versus native joint infections (NJIs).
Main Methods:
- Retrospective analysis of 192 culture-positive synovial fluid samples from January 2018 to January 2020.
- Statistical comparison using Mann-Whitney U test for metric data and Chi-squared tests for nominal data.
Main Results:
- Coagulase-negative Staphylococci (CNS) were 2.5-fold more frequent in PJIs (33.9%) than NJIs (13.4%).
- Staphylococcus aureus (S. aureus) was 3.2-fold more common in NJIs (52.2%) than PJIs (16.4%).
- CNS and S. aureus were the most prevalent pathogens in both infection types.
Conclusions:
- Pathogen profiles in PJIs and NJIs are considerably different.
- CNS and S. aureus are key pathogens in both PJIs and NJIs, informing empirical antimicrobial therapy.
- Microbiologic identification remains essential for targeted treatment of joint infections.
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