Factors associated with late microbiological documentation of prosthetic joint infection

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Medical Microbiology

Background:

• Prosthetic joint infections (PJIs) pose a significant challenge in orthopedic surgery.
• Timely diagnosis and documentation of PJIs are crucial for effective management.
• Late documentation can complicate treatment strategies and patient outcomes.

Purpose of the Study:

• To quantify the incidence of prosthetic joint infections (PJIs) with delayed documentation.
• To identify factors associated with the late documentation of bacterial PJIs.
• To inform strategies for optimizing antibiotic treatment timing in PJI cases.

Main Methods:

• Retrospective analysis of bacterial PJIs requiring surgical management from November 2015 to November 2019.
• Inclusion of data from a French healthcare center.
• Analysis of short-term (72-hour) and late (14-day) microbiological culture results.

Main Results:

• A total of 160 PJIs were identified, involving 215 bacteria.
• Late documentation was observed in 29 patients (18.1%).
• Coagulase-negative staphylococci and Cutibacterium spp. were the most frequently isolated bacteria (60%).
• Multivariate analysis revealed late chronic PJI (OR=2.47) and pre-surgical antibiotic therapy (OR=3.13) as significant factors associated with late-documented infections.

Conclusions:

• Understanding factors contributing to late-documented PJIs is essential for clinical practice.
• Identifying these factors can help streamline and optimize antibiotic therapy.
• This knowledge supports timely intervention for better patient management in prosthetic joint infections.