Streptococcal and Staphylococcus aureus prosthetic joint infections: are they really different?

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Microbiology

Background:

• Staphylococci and streptococci are leading causes of prosthetic joint infections (PJIs).
• Understanding treatment outcomes for specific pathogens is crucial for effective management.

Purpose of the Study:

• To compare the outcomes of streptococcal and methicillin-susceptible Staphylococcus aureus (MSSA) prosthetic joint infections (PJIs).
• To analyze reinfection-free survival rates based on different treatment strategies.

Main Methods:

• Prospective cohort study of monomicrobial streptococcal and MSSA PJIs.
• Analysis of 209 patients managed between 2010-2017.
• Primary outcome: cumulative 2-year reinfection-free survival.

Main Results:

• Streptococcal PJI patients were older with more hematogenous infections.
• Overall 2-year reinfection-free survival was higher for streptococcal PJI (91%) vs MSSA PJI (81%).
• Higher survival after DAIR (87% vs 60%) and SAT (100% vs 31%) for streptococcal PJI; no difference after exchange arthroplasty (89% vs 93%).

Conclusions:

• Reinfection-free survival is better for streptococcal PJI compared to MSSA PJI following DAIR and SAT.
• Prosthesis exchange yields similar outcomes for both streptococcal and MSSA PJIs.
• Treatment strategy significantly impacts outcomes in PJI management.