Infection and Drug Resistance (Jun 2021)
Microbiology of Periprosthetic Hip and Knee Infections in Surgically Revised Cases from 34 Centers in Mainland China
Abstract
Hui-Ming Peng,1 Zong-Ke Zhou,2 Fei Wang,3 Shi-Gui Yan,4 Peng Xu,5 Xi-Fu Shang,6 Jia Zheng,7 Qing-Sheng Zhu,8 Li Cao,9 Xi-Sheng Weng1 1Department of Orthopedics, Peking Union Medical College Hospital, CAMS & PUMC, Beijing, 100730, People’s Republic of China; 2Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People’s Republic of China; 3Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei Province, People’s Republic of China; 4Department of Orthopedic Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang Province, People’s Republic of China; 5Department of Adult Joint Reconstruction, Xi’ an Honghui Hospital, Xi’ An, 710054, Shaanxi Province, People’s Republic of China; 6Department of Orthopedic Surgery, First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, Anhui Province, People’s Republic of China; 7Department of Orthopedic Surgery, Henan Provincial People’s Hospital, Zhengzhou, 450003, Henan Province, People’s Republic of China; 8Department of Orthopedic Surgery, Xijing Hospital of Air Force Medical University, Xi’ An, 710032, Shanxi Province, People’s Republic of China; 9Department of Orthopedic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, People’s Republic of ChinaCorrespondence: Xi-Sheng WengDepartment of Orthopedics, Peking Union Medical College Hospital, CAMS & PUMC, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, People’s Republic of ChinaTel/Fax +86-10-69152710Email [email protected] and Aim: Periprosthetic joint infection (PJI) is one of the most devastating complications after total joint arthroplasty (TJA). However, the antibiotic resistance of infecting pathogens can significantly vary in different parts of the country. In the current study, we analyzed the demographic and microbiological profiles of knee and hip PJI over three years and compared the microbiological differences between them.Methods: A multicenter retrospective study of PJI patients in 34 referral medical centers in mainland China from January 2015 to November 2017 was performed.Results: A total of 925 PJI patients were recruited, 452 were identified as knee PJIs, and 473 were hip PJIs. The most common causative pathogens were Staphylococcus aureus (26.5%) and coagulase-negative staphylococci (14.3%). Methicillin-resistant staphylococci were involved in 25.6% (237/925) of all PJI cases. Mycobacterium and fungus only accounted for 6.5% (61) of all cases. Enteric gram-negative bacilli, anaerobes, and polymicrobial pathogens were more common in hip joint prostheses than in knee PJI (P = 0.014; P = 0.006; P = 0.002, respectively).Conclusion: While the majority of causative pathogens in PJI cases are staphylococcal species, the prevalence of atypical organisms and resistant pathogens should also be given attention and warrant the need for empiric antibiotic treatment.Keywords: arthroplasty, hips, knees, microorganism, prosthetic joint infection
