Microbiology analysis of periprothetic joint infection post total hip and knee arthroplasty of 9 centers in Beijing between 2014 and 2016

Huiming Peng; Longchao Wang; Jiying Chen; Yixin Zhou; Hua Tian; Jianhao Lin; Wanshou Guo; Yuan Lin; Tiebing QU; Ai Guo; Yongping Cao; Xisheng Weng

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Microbiology analysis of periprothetic joint infection post total hip and knee arthroplasty of 9 centers in Beijing between 2014 and 2016

VernacularTitle: 2014—2016年北京市9家医院人工髋膝关节置换术后假体周围感染患者微生物学的多中心调查研究
Author: Huiming PENG ¹ ; Longchao WANG ² ; Jiying CHEN ³ ; Yixin ZHOU ⁴ ; Hua TIAN ⁵ ; Jianhao LIN ⁶ ; Wanshou GUO ⁷ ; Yuan LIN ⁸ ; Tiebing QU ⁹ ; Ai GUO ¹⁰ ; Yongping CAO ¹¹ ; Xisheng WENG ¹
Author Information

1. Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
2. Department of Orthopedics, Guangdong Provincial People′s Hospital, Guangzhou 510080, China
3. Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China
4. Department of Orthopedics, Beijing Jishuitan Hospital, Beijing 100035, China
5. Department of Orthopedics, Peking University Third Hospital, Beijing 100083, China
6. Department of Orthopedics, Peking University People′s Hospital, Beijing 100044, China
7. Department of Orthopedics, Sino-Japanese Friendship Hospital, Beijing 100029, China
8. Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
9. Department of Orthopedics, China Rehabilitation Research Center Beijing Boai Hospital, Beijing 100068, China
10. Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
11. Department of Orthopedics, Peking University First Hospital, Beijing 100034, China
Publication Type:Journal Article
Keywords: Arthroplasty, replacement, hip; Arthroplasty, replacement, knee; Bacteria; Antibiotics; Infection
From: Chinese Journal of Surgery 2019;57(8):596-600
CountryChina
Language:Chinese
Abstract: Objective:To investigate the microbiological test, antibiotic sensitivity and surgical treatment of periprosthetic joint infection(PJI) cases in post total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients.
Methods:A retrospective cross-sectional survey was conducted on 318 patients who underwent THA or TKA in 9 clinical centers in Beijing from January 2014 to December 2016.The data of microbiology, antibiotic sensitivity and surgical treatment were collected.The average age of patients was (62.3±13.1) years old (range: 21-86 years old), including 145 males and 173 females.The body mass index was (25.6±3.8) kg/m ² (range: 15.6-38.1 kg/m²).
Results:In total, 318 patients had microorganisms detected by periprosthetic tissue culture or synovial fluid culture, 209 cases (65.7%) had Gram-positive bacteria, 29 cases (9.1%) had Gram-negative bacteria, 10 cases (3.1%) had fungi, 3 cases (0.9%) had non-tuberculous mycobacteria, 72 cases (22.6%) were negative, 69 cases (21.7%) had methicillin-resistant bacteria. The antibiotic sensitivity results showed that the overall resistance rate of penicillin, cefuroxime, amoxicillin+clavulanic acid was 79.9%, 69.9%, and 68.1%, respectively; meropenem, vancomycin, and linezolid resistance rate was 0. For the treatment methods of hip and knee PJI, two-stage revision surgery acounted for 72.9% (108/148) and 64.1% (109/170), respectively. One-stage revision surgery accounted for 21.6% (32/148) and 7.6% (13/170), and open debridement surgery accounted for 4.7%(7/148) and 26.4% (45/170).
Conclusions:Gram-positive bacteria was still the main pathogen of PJI.The methicillin-resistant bacteria and rare bacteria should be payed attention to. The Majority of hip and knee PJI cases were treated by two-stage revision surgery.