What Is the Rate of Antimicrobial Resistance of a Prosthetic Joint Infection in a Major Orthopaedic Centre?

Area of Science:

• Orthopedics
• Infectious Diseases
• Microbiology

Background:

• Periprosthetic joint infections (PJIs) are a major complication following hip and knee arthroplasties.
• Addressing PJIs is crucial for improving the long-term success of joint replacement surgeries.
• Understanding causative pathogens and their antibiotic resistance patterns is essential for effective infection control.

Purpose of the Study:

• To investigate the epidemiological data of microorganisms responsible for PJIs.
• To determine the antibiotic resistance patterns (antibiograms) of these pathogens.
• To inform rational antibiotic use and future infection control strategies for PJIs.

Main Methods:

• Retrospective analysis of 121 patients undergoing two-stage revision surgery for PJI.
• Data collection included demographics, comorbidities, arthroplasty site, and microbiological culture results.
• Synovial fluid and deep tissue cultures were analyzed for causative pathogens and their sensitivities.

Main Results:

• 35.5% of PJI cases were culture-negative, and 9.9% showed polymicrobial infections.
• Gram-positive microorganisms (50.4%) were most common, followed by Gram-negative (23.1%) and fungi (0.8%).
• High resistance rates observed: Methicillin resistance in 64.3% of S. aureus and 89.5% of CoNS; 68.4% ESBL rate in Enterobacteriaceae.

Conclusions:

• Antibiotic resistance is prevalent in over half of PJI cases, affecting common causative microorganisms.
• Culture-negative PJIs and isolation of resistant pathogens significantly decrease treatment success.
• Findings underscore the need for targeted antibiotic strategies and improved diagnostics in PJI management.