Improved cure rate of periprosthetic joint infection through targeted antibiotic therapy based on integrated pathogen diagnosis strategy

Qijin Wang; Qijin Wang; Qijin Wang; Qijin Wang; Yongfa Chen; Yongfa Chen; Yongfa Chen; Yang Chen; Yang Chen; Yang Chen; Jianhua Lv; Jianhua Lv; Jianhua Lv; Haiqi Ding; Haiqi Ding; Haiqi Ding; Jiagu Huang; Jiagu Huang; Jiagu Huang; Jiexin Huang; Jiexin Huang; Jiexin Huang; Zida Huang; Zida Huang; Zida Huang; Bin Yang; Wenming Zhang; Wenming Zhang; Wenming Zhang; Xinyu Fang; Xinyu Fang; Xinyu Fang

doi:10.3389/fcimb.2024.1388385

Frontiers in Cellular and Infection Microbiology (May 2024)

Improved cure rate of periprosthetic joint infection through targeted antibiotic therapy based on integrated pathogen diagnosis strategy

Qijin Wang,
Qijin Wang,
Qijin Wang,
Qijin Wang,
Yongfa Chen,
Yongfa Chen,
Yongfa Chen,
Yang Chen,
Yang Chen,
Yang Chen,
Jianhua Lv,
Jianhua Lv,
Jianhua Lv,
Haiqi Ding,
Haiqi Ding,
Haiqi Ding,
Jiagu Huang,
Jiagu Huang,
Jiagu Huang,
Jiexin Huang,
Jiexin Huang,
Jiexin Huang,
Zida Huang,
Zida Huang,
Zida Huang,
Bin Yang,
Wenming Zhang,
Wenming Zhang,
Wenming Zhang,
Xinyu Fang,
Xinyu Fang,
Xinyu Fang

Affiliations

Qijin Wang: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Qijin Wang: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Qijin Wang: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Qijin Wang: Department of Orthopaedic Surgery, The Affiliated Mindong Hospital of Fujian Medical University, Fuan, China
Yongfa Chen: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Yongfa Chen: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Yongfa Chen: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Yang Chen: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Yang Chen: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Yang Chen: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jianhua Lv: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jianhua Lv: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jianhua Lv: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Haiqi Ding: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Haiqi Ding: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Haiqi Ding: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jiagu Huang: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jiagu Huang: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jiagu Huang: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jiexin Huang: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jiexin Huang: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Jiexin Huang: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Zida Huang: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Zida Huang: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Zida Huang: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Bin Yang: Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Wenming Zhang: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Wenming Zhang: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Wenming Zhang: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Xinyu Fang: Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Xinyu Fang: Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Xinyu Fang: Fujian Provincial Institute of Orthopedics, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China

DOI: https://doi.org/10.3389/fcimb.2024.1388385
Journal volume & issue: Vol. 14

Abstract

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ObjectivesThis study aimed to determine whether combined of pathogen detection strategies, including specimen acquisition, culture conditions, and molecular diagnostics, can improve treatment outcomes in patients with periprosthetic joint infections (PJI).MethodsThis retrospective study included suspected PJI cases from three sequential stages at our institution: Stage A (July 2012 to June 2015), Stage B (July 2015 to June 2018), and Stage C (July 2018 to June 2021). Cases were categorized into PJI and aseptic failure (AF) groups based on European Bone and Joint Infection Society (EBJIS) criteria. Utilization of pathogen diagnostic strategies, pathogen detection rates, targeted antibiotic prescription rates, and treatment outcomes were analyzed and compared across the three stages.ResultsA total of 165 PJI cases and 38 AF cases were included in this study. With the progressive implementation of the three optimization approaches across stages A, B and C, pathogen detection rates exhibited a gradual increase (χ2 = 8.282, P=0.016). Similarly, utilization of targeted antibiotic therapy increased stepwise from 57.1% in Stage A, to 82.3% in Stage B, and to 84% in Stage C (χ2 = 9.515, P=0.009). The 2-year infection control rate exceeded 90% in both stages B and C, surpassing stage A (71.4%) (χ2 = 8.317, P=0.011). Combined application of all three optimized protocols yielded the highest sensitivity of 91.21% for pathogen detection, while retaining higher specificity of 92.11%.ConclusionThe utilization of combined pathogen diagnostic strategies in PJI can increase pathogen detection rates, improve targeted antibiotic prescription, reduce the occurrence of antibiotic complications, and achieve better treatment outcomes.

Published in Frontiers in Cellular and Infection Microbiology

ISSN: 2235-2988 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Science: Microbiology
Website: http://www.frontiersin.org/Cellular-and-Infection-Microbiology

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