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Microbiological Profile of Periprosthetic Joint Infections: A Retrospective Analysis from North India

Souradeep Chowdhury1, Sunit Sikdar1, Rajesh Malhotra2

  • 1Department of Medicine and Microbiology, All India Institute of Medical Sciences, New Delhi, India.

The American Journal of Tropical Medicine and Hygiene
|October 29, 2024
PubMed

Insights

Prosthetic joint infections (PJIs) are a growing concern after joint replacement surgery. In India, multidrug-resistant gram-negative bacteria are the primary cause of these infections, complicating treatment decisions.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Microbiology

Background:

  • Prosthetic joint infections (PJIs) are a significant complication following total joint arthroplasty, increasing patient morbidity.
  • The spectrum of causative pathogens and antimicrobial resistance patterns for PJIs vary geographically, impacting empirical antibiotic selection.
  • Rising rates of drug-resistant organisms necessitate updated epidemiological data for effective PJI management.

Purpose of the Study:

  • To identify the common bacterial organisms causing PJIs in a tertiary care hospital in India.
  • To determine the prevalence of multidrug-resistant organisms (MDROs) among PJI pathogens in this region.
  • To understand the specific resistance patterns, particularly carbapenem resistance, in gram-negative PJI isolates.

Main Methods:

  • Retrospective analysis of patient records with orthopedic implants undergoing surgery.
  • Intraoperative tissue samples were collected for sonication and subsequent microbiological culture.
  • Identification of bacterial isolates and antimicrobial susceptibility testing were performed.

Main Results:

  • The most frequent isolates were Staphylococcus aureus (16.3%), Pseudomonas aeruginosa (13.9%), Staphylococcus epidermidis (12.8%), and Klebsiella pneumoniae (12.8%).
  • A high prevalence of multidrug-resistant organisms was observed among the PJI isolates.
  • Notably, 35% of gram-negative isolates exhibited resistance to carbapenems.

Conclusions:

  • Multidrug-resistant gram-negative bacteria are the predominant drivers of prosthetic joint infections in the studied Indian setting.
  • The findings highlight the urgent need for regional surveillance of PJI pathogens and resistance trends.
  • Current antibiotic strategies for empiric treatment of PJIs in this region require careful consideration of local resistance patterns, especially for gram-negative pathogens.

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