Microbiological pathogen analysis in native versus periprosthetic joint infections: a retrospective study

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.