Staphylococcus lugdunensis prosthetic joint infection: A multicentric cohort study

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Microbiology

Background:

• Staphylococcus lugdunensis is an increasingly recognized cause of prosthetic joint infections (PJI).
• Management and outcomes of S. lugdunensis PJI require further investigation to optimize patient care.
• Understanding risk factors and treatment efficacies is critical for improving PJI management.

Purpose of the Study:

• To describe the management strategies and clinical outcomes for patients with Staphylococcus lugdunensis prosthetic joint infections (PJI).
• To identify determinants of treatment failure in S. lugdunensis PJI.
• To evaluate the effectiveness of different surgical approaches and antimicrobial therapies.

Main Methods:

• A multicentric retrospective cohort study included 111 adult patients with proven S. lugdunensis PJI.
• Surgical management options included debridement, antibiotic with implant retention (DAIR), two-stage, or one-stage exchange.
• Logistic regression and Kaplan-Meier survival analysis were used to assess failure determinants.

Main Results:

• The study included 111 patients with knee or hip PJI, predominantly chronic.
• Overall treatment failure rate was 19.8%. Independent determinants for failure included diabetes, sinus tract, and DAIR approach.
• Rifampin-based regimens were associated with a lower failure rate, while hip location and elevated pre-surgical CRP levels predicted failure in DAIR cases.

Conclusions:

• Staphylococcus lugdunensis PJI presents a significant challenge in prosthetic joint infection management.
• Optimal surgical intervention, tailored antimicrobial therapy, and consideration of patient-specific factors are pivotal for successful treatment.
• Further research into specific treatment protocols for S. lugdunensis PJI is warranted.