Microorganisms (Apr 2024)

Prosthetic Joint Infections Caused by <i>Mycobacterium tuberculosis</i> Complex—An ESGIAI–ESGMYC Multicenter, Retrospective Study and Literature Review

  • Alvaro Auñon,
  • Llanos Salar-Vidal,
  • Ignacio Mahillo-Fernandez,
  • Francisco Almeida,
  • Pedro Pereira,
  • Jaime Lora-Tamayo,
  • Tristan Ferry,
  • Sarah Souèges,
  • Aurélien Dinh,
  • Rosa Escudero,
  • Candela Menéndez Fernández-Miranda,
  • Alicia Rico,
  • Nicolo Rossi,
  • Jaime Esteban

DOI
https://doi.org/10.3390/microorganisms12050849
Journal volume & issue
Vol. 12, no. 5
p. 849

Abstract

Read online

Purpose: While tuberculosis remains a significant global health concern, prosthetic joint infections (PJIs) caused by members of the Mycobacterium tuberculosis complex are exceptionally rare. Our objective is to perform a retrospective search of new cases of this disease and analyze all cases available in the literature of tuberculous PJIs, aiming to detect factors that may influence patient outcomes. Methods: The ESGIAI and ESGMYC study groups were used to collect information on non-published cases of tuberculous prosthetic joint infections (PJIs). Additionally, a literature review of all published cases of tuberculous PJIs was conducted. All identified cases in the retrospective study and in the literature review were merged and included in the statistical analysis, involving both univariate and multivariate analyses. Results: Fifteen previously unreported cases of tuberculous prosthetic joint infections (PJIs) from four countries were detailed. Among them, ten patients were female, with a median age of 76 years. The hip was affected in 13 cases. Seven patients experienced co-infection with another microorganism. Treatment approaches varied, with 13 patients undergoing implant removal, one treated with DAIR (debridement, antibiotics, and implant retention), and one case was treated with an unknown treatment method. All patients received antibiotic therapy and achieved a cure. The literature review that was conducted detected 155 published cases. Univariate analysis revealed a statistical significance for previous tuberculosis, joint, and no importance of surgery for cure. Conclusions: Tuberculous prosthetic joint infection (PJI) is a rare condition, typically presenting as a localized chronic infection. Antibiotic treatment is essential for the management of these patients, but neither surgical treatment nor duration of treatment seems to have importance in the outcome.

Keywords