Group B streptococcus in prosthetic hip and knee joint-associated infections

被引:36
作者
Sendi, P. [1 ]
Christensson, B. [2 ]
Uckay, I. [3 ]
Trampuz, A. [4 ]
Achermann, Y. [5 ]
Boggian, K. [6 ]
Svensson, D. [7 ]
Widerstrom, M. [8 ]
Zimmerli, W. [1 ]
机构
[1] Univ Basel, Med Clin Liestal, Infect Dis Unit, Liestal, Switzerland
[2] Lund Univ, Dept Clin Sci, Div Infect Med, Lund, Sweden
[3] Univ Hosp Geneva, Orthopaed Surg Serv, Geneva, Switzerland
[4] Univ Basel Hosp, Div Infect Dis & Hosp Epidemiol, CH-4031 Basel, Switzerland
[5] Cantonal Hosp Zug, Infect Dis Serv, Baar, Switzerland
[6] Kantonsspital St Gallen, Div Infect Dis & Hosp Epidemiol, St Gallen, Switzerland
[7] Lund Univ, Dept Clin Sci, Infect Dis Res Unit, Malmo, Sweden
[8] Ostersund Hosp, Dept Infect Dis, Ostersund, Sweden
关键词
Group B streptococcus; Prosthesis-related infections; Streptococcus; NONPREGNANT ADULTS; DEBRIDEMENT; RETENTION; ARTHROPLASTY; DIAGNOSIS; THERAPY; DISEASE;
D O I
10.1016/j.jhin.2011.04.022
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The incidence of invasive group B streptococcus (GBS) infections in non-pregnant adults is increasing. Little is known about GBS in periprosthetic joint infections (PJIs). We aimed to analyse the clinical presentation of GBS PJI and its treatment in association with the outcome. The characteristics of 36 GBS PJIs collected from 10 centres were investigated. In 34 episodes, follow-up examination of >= 2 years was available, allowing treatment and outcome analysis. Most infections (75%) occurred >= 3 months after implantation. Most patients (91%) had at least one comorbidity; 69% presented with acute symptoms and 83% with damaged periprosthetic soft tissue. In 20 of 34 episodes debridement and retention of implant was attempted, but in five of these the prosthesis was ultimately removed. Hence, in 19 (56%) episodes, the implant was removed, including 14 immediate removals. In four episodes the removal was permanent. Penicillin derivatives and clindamycin were the most common antimicrobials administered (68%). In 94% the infection was cured, and in 82% functional mobility preserved. Debridement with implant retention was successful if the duration of symptoms was short, the prosthesis stable, and the tissue damage minor (10/10 vs 3/10 episodes, P = 0.003). Surgery that complied with a published algorithm was associated with a favourable outcome (P = 0.049). (C) 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:64 / 69
页数:6
相关论文
共 32 条
[1]  
AHLBERG A, 1978, CLIN ORTHOP RELAT R, P69
[2]   SYNERGISM, KILLING KINETICS, AND ANTI-MICROBIAL SUSCEPTIBILITY OF GROUP-A AND GROUP-B STREPTOCOCCI [J].
BAKER, CN ;
THORNSBERRY, C ;
FACKLAM, RR .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1981, 19 (05) :716-725
[3]   ANTIBIOTIC-RESISTANCE AND PENICILLIN TOLERANCE IN CLINICAL ISOLATES OF GROUP-B STREPTOCOCCI [J].
BETRIU, C ;
GOMEZ, M ;
SANCHEZ, A ;
CRUCEYRA, A ;
ROMERO, J ;
PICAZO, JJ .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1994, 38 (09) :2183-2186
[4]  
BLISS DG, 1985, CLIN ORTHOP RELAT R, P207
[5]   PROSTHETIC HIP-JOINT INFECTION ASSOCIATED WITH A PENICILLIN-TOLERANT GROUP-B STREPTOCOCCUS [J].
CUNNINGHAM, R ;
WALKER, C ;
RIDGWAY, E .
JOURNAL OF INFECTION, 1992, 25 (01) :77-&
[6]   LATE INFECTION AFTER TOTAL HIP-REPLACEMENT [J].
DOWNES, EM .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1977, 59 (01) :42-44
[7]  
Duggan J M, 2001, J South Orthop Assoc, V10, P209
[8]  
DUGGAN JM, 2001, J S ORTHOP ASS, V10, P214
[9]   Successful antimicrobial therapy and implant retention for streptococcal infection of prosthetic joints [J].
Everts, RJ ;
Chambers, ST ;
Murdoch, DR ;
Rothwell, AG ;
McKie, J .
ANZ JOURNAL OF SURGERY, 2004, 74 (04) :210-214
[10]   Management of infection associated with total hip arthroplasty according to a treatment algorithm [J].
Giulieri, SG ;
Graber, P ;
Ochsner, PE ;
Zimmerli, W .
INFECTION, 2004, 32 (04) :222-228