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Comprehensive analysis of the pathogen spectrum and antibiotic resistance profiles in periprosthetic joint
Qianqian Cao1, Panlong Fan1, Jiawei Feng2
1Department of Orthopedics, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
Objective:
The objective of this study was to preliminarily examine the demographic profiles, the spectrum of pathogenic bacteria, and the antibiotic resistance patterns among patients with periprosthetic joint infection (PJI), while also offering deeper insights into the microbiological characteristics specifically in diabetic patients with PJI.
Methods:
A retrospective analysis of 278 patients diagnosed with PJI from January 2019 to December 2024 at our institution was performed. Demographic characteristics of the patients, the distribution of pathogenic bacteria, and data on antibiotic resistance were statistically analyzed employing the chi-square test and t-test.
Results:
Gram-positive cocci comprised 56.6% of all pathogenic bacteria, whereas coagulase-negative staphylococci constituted 28.1% of the total. Throughout the study period, a significant decrease was observed in the proportion of rifampicin-resistant coagulase-negative staphylococci (CoNS), from 27.0% to 10.4%. Similarly, a marked decline was noted in the proportion of gentamicin-resistant Staphylococcus aureus, from 50.0% to 15.4%. Conversely, there was a dramatic increase in the proportion of amoxicillin-clavulanate-resistant gram-negative bacilli, from 23.1% to 64.7%. The incidence of fungal infections was notably higher among diabetic patients with PJI compared to their non-diabetic counterparts.
Conclusion:
This study demonstrates that the distribution pattern of pathogenic bacteria and their antibiotic resistance profiles among patients with PJI undergoes continuous variation. Moreover, there exist significant differences in the distribution of pathogenic bacteria between those with diabetes and those without diabetes among PJI patients. This serves as a crucial theoretical foundation and empirical support for the rigorous and tailored development of anti-infective treatment strategies for patients with various types of PJI.
Insights
Periprosthetic joint infection (PJI) bacterial resistance is changing, with decreasing resistance in some bacteria but increasing resistance to amoxicillin-clavulanate in gram-negative bacilli. Diabetic patients with PJI show higher fungal infection rates.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Periprosthetic joint infection (PJI) poses a significant challenge in orthopedic surgery.
- Understanding the evolving landscape of microbial pathogens and their antibiotic resistance is crucial for effective treatment.
Purpose of the Study:
- To analyze demographic profiles, bacterial spectrum, and antibiotic resistance patterns in PJI patients.
- To investigate microbiological characteristics specific to diabetic patients with PJI.
Main Methods:
- Retrospective analysis of 278 PJI patients from January 2019 to December 2024.
- Statistical analysis of demographic data, bacterial distribution, and antibiotic resistance using chi-square and t-tests.
Main Results:
- Gram-positive cocci (56.6%) and coagulase-negative staphylococci (28.1%) were predominant.
- Significant decrease in rifampicin-resistant CoNS (27.0% to 10.4%) and gentamicin-resistant Staphylococcus aureus (50.0% to 15.4%).
- Dramatic increase in amoxicillin-clavulanate-resistant gram-negative bacilli (23.1% to 64.7%); higher fungal infection rates in diabetic PJI patients.
Conclusions:
- PJI bacterial distribution and antibiotic resistance patterns are dynamic.
- Significant differences in bacterial distribution exist between diabetic and non-diabetic PJI patients.
- Findings support tailored anti-infective strategies for diverse PJI cases.
