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Sex-Specific Differences in Microbiological Patterns and Outcomes in Periprosthetic Joint Infection.

Sophie Bapst1, Leonard Knoll1, Emanuel Francis Liechti2

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Summary

This study compared periprosthetic joint infections (PJI) in men and women. While overall outcomes were similar, women with Gram-negative rod infections experienced higher failure rates, highlighting sex-specific differences in PJI treatment.

Keywords:
Gram-negative rodsmicrobiologyoutcomeperiprosthetic joint infectionsex

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Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Sex-Specific Medicine

Background:

  • Periprosthetic joint infections (PJI) are a significant complication following joint replacement surgery.
  • The influence of biological sex on PJI etiology and treatment outcomes remains largely unexplored.

Purpose of the Study:

  • To investigate sex-specific differences in microbiology and treatment outcomes for periprosthetic joint infections (PJI).
  • To provide a sex-specific perspective on the management and prognosis of PJI.

Main Methods:

  • Retrospective analysis of 294 PJI cases between 2015 and 2022, categorized by biological sex.
  • Comparison of microbiological data and treatment outcomes using appropriate statistical tests (Fisher's exact, Mann-Whitney U).
  • Infection-free survival assessed via Kaplan-Meier analysis and log-rank testing.

Main Results:

  • Women experienced a higher incidence of PJI caused by Gram-negative rods compared to men (18.8% vs. 5.9%).
  • No significant differences in overall infection failure rates were observed between sexes (25.3% in men vs. 26.8% in women).
  • Women with Gram-negative rod PJI showed a higher failure rate than men with the same pathogen.

Conclusions:

  • Overall treatment outcomes for PJI are comparable between men and women.
  • A notable exception exists for PJI caused by Gram-negative rods, where women exhibit a higher failure rate.
  • These findings underscore the importance of considering sex-specific factors in PJI management, particularly concerning Gram-negative infections.