dc.contributor.author
Renz, Nora
dc.contributor.author
Trebse, Rihard
dc.contributor.author
Akgün, Doruk
dc.contributor.author
Perka, Carsten
dc.contributor.author
Trampuz, Andrej
dc.date.accessioned
2020-01-08T13:05:04Z
dc.date.available
2020-01-08T13:05:04Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/26346
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-26107
dc.description.abstract
BACKGROUND:
Treatment of enterococcal periprosthetic joint infections (PJI) is challenging due to non-standardized management strategies and lack of biofilm-active antibiotics. The optimal surgical and antimicrobial therapy are unknown. Therefore, we evaluated characteristics and outcome of enterococcal PJI.
METHODS:
Consecutive patients with enterococcal PJI from two specialized orthopedic institutions were retrospectively analyzed. Both institutions are following the same diagnostic and treatment concepts. The probability of relapse-free survival was estimated using Kaplan-Meier survival curves and compared by log-rank test. Treatment success was defined by absence of relapse or persistence of PJI due to enterococci or death related to enterococcal PJI. Clinical success was defined by the infection-free status, no subsequent surgical intervention for persistent or perioperative infection after re-implantation and no PJI-related death within 3 months.
RESULTS:
Included were 75 enterococcal PJI episodes, involving 41 hip, 30 knee, 2 elbow and 2 shoulder prostheses. PJI occurred postoperatively in 61 episodes (81%), hematogenously in 13 (17%) and by contiguous spread in one. E. faecalis grew in 64 episodes, E. faecium in 10 and E. casseliflavus in one episode(s). Additional microorganism(s) were isolated in 38 patients (51%). Enterococci were susceptible to vancomycin in 73 of 75 isolates (97%), to daptomycin in all 75 isolates, and to fosfomycin in 21 of 22 isolates (96%). The outcome data was available for 66 patients (88%). The treatment success after 3 years was 83.7% (95% confidence interval [CI]; 76.1-96.7%) and the clinical success was 67.5% (95% CI; 57.3-80.8%). In 11 patients (17%), a new PJI episode caused by a different pathogen occurred. All failures occurred within 3 years after surgery.
CONCLUSION:
About half of enterococcal PJI were polymicrobial infections. The treatment success was high (84%). All treatment failures occurred within the first 3 years after revision surgery. Interestingly, 17% of patients experienced a new PJI caused by another pathogen at a later stage.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Periprosthetic joint infection
en
dc.subject
Enterococcus spp.
en
dc.subject
Microbiology
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Enterococcal periprosthetic joint infection: clinical and microbiological findings from an 8-year retrospective cohort study
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
1083
dcterms.bibliographicCitation.doi
10.1186/s12879-019-4691-y
dcterms.bibliographicCitation.journaltitle
BMC Infectious Diseases
dcterms.bibliographicCitation.number
1
dcterms.bibliographicCitation.originalpublishername
BMC
dcterms.bibliographicCitation.volume
19
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
31881851
dcterms.isPartOf.eissn
1471-2334