Microbiological Profiles and Antibiotic Resistance of Periprosthetic Knee and Hip Infections: A Retrospective Study

Abstract

INTRODUCTION: The aim of this study was to investigate microbiological profiles and antimicrobial resistance of hip and knee periprosthetic joint infection (PJI). METHODS: Patients over 18 years of age who underwent hip or knee primary arthroplasty between September 2018 and January 2022 were screened from the hospital database and retrospectively included in the study. Patients' demographic data, periprosthetic tissue culture, and joint fluids' antimicrobial resistances were evaluated. RESULTS: A total of 51 patients with 66.7% being female were enrolled. The hip joint was infected in 62.7% of the patients. The most common causative pathogen identified was Coagulase-negative staphylococci (CoNS) (41.2%), followed by Staphylococcus aureus (23.5%) and Acinetobacter baumanii (23.5%). The proportion of A. baumanii in hip PJI was higher than that in knee PJI (p=0.02). Twenty-five of the detected Acinetobacter strains were resistant to carbapenems. The distribution of Gram-positive or Gram-negative microorganisms between the knee and hip PJI groups was not statistically significant (p>0.05). The infection was monobacterial in 56.9% of the patients. Polymicrobial pathogens were more likely to occur in the hip prosthetic joint than in the knee prosthetic joint, but no statistical difference was observed between the two groups (p>0.05). DISCUSSION AND CONCLUSION: The predominant bacteria usually differ among different geographic area and location of the prosthesis. Knowing the causative agents and antimicrobial resistance is the basic strategy in infection management. Considering that there are limited evidence in literature about PJI's, further studies are needed to accumulate knowledge and to analyze better microbiological profiles of PJIs.

Keywords

• hip
• knee
• microorganism
• pathogen
• prosthetic joint infection
• resistance
• susceptibility.