How to Handle Concomitant Asymptomatic Prosthetic Joints during an Episode of Hematogenous Periprosthetic Joint Infection, a Multicenter Analysis
Wouthuyzen-Bakker, Marjan (Department of Medical Microbiology and Infection Prevention. University of Groningen. University Medical Center Groningen)
Sebillotte, Marine (Department of Infectious Diseases and Intensive Care Medicine. Rennes University Hospital)
Arvieux, Cedric (Great West Reference Centers for Complex Bone and Joint Infections (CRIOGO))
Fernandez-Sampedro, Marta (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Senneville, Eric (Department of Infectious Diseases Lille. University Hospital Gustave Dron Hospital)
Barbero, José Maria (Hospital Universitario Príncipe de Asturias (Alcalá de Henares, Madrid))
Lora-Tamayo, Jaime (Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12))
Aboltins, Craig (University of Melbourne. Northern Clinical School)
Trebse, Rihard (Service for Bone Infections. Valdoltra Orthopaedic Hospital. Faculty of Medicine. University of Ljublijana)
Salles, Mauro José (Santa Casa de São Paulo School of Medical Sciences and Musculoskeletal Infection Group. Federal University of São Paulo)
Kramer, Tobias Siegfied (Evangelisches Waldkrankenhaus Spandau)
Ferrari, Mateo Carlo (Istituto di Ricovero e Cura A Carattere Scientifico (IRCCS))
Garcia-Cañete, Joaquín (Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz)
Benito, Natividad (Institut d'Investigació Biomèdica Sant Pau)
Diaz-Brito, Vicens (Parc Sanitari Sant Joan de Deu. Sant Boi)
del Toro López, María Dolores (Unidad Clínica de Enfermedades Infecciosa y Microbiología. Universidad de Sevilla. Instituto de Biomedicina de Sevilla (IBIS))
Scarborough, Matthew (Bone Infection Unit. Nuffield Orthopaedic Centre. Oxford University Hospitals National Health Service (NHS) Foundation Trust)
Soriano, A (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	Background: Prosthetic joints are at risk of becoming infected during an episode of bacteremia, especially during Staphylocococcus aureus bacteremia. However, it is unclear how often asymptomatic periprosthetic joint infection (PJI) occurs, and whether additional diagnostics should be considered. Methods: In this multicenter study, we retrospectively analyzed a cohort of patients with a late acute (hematogenous) PJI between 2005-2015 who had concomitant prosthetic joints in situ. Patients without at least 1 year of follow-up were excluded. Results: We included 91 patients with a hematogenous PJI and 108 concomitant prosthetic joints. The incident PJI was most frequently caused by Staphylococcus aureus (43%), followed by streptococci (26%) and Gram-negative rods (18%). Of 108 concomitant prosthetic joints, 13 were symptomatic, of which 10 were subsequently diagnosed as a second PJI. Of the 95 asymptomatic prosthetic joints, 1 PJI developed during the follow-up period and was classified as a "missed"PJI at the time of bacteremia with S. aureus (1. 1%). Infected prosthetic joints were younger than the noninfected ones in 67% of cases, and prosthetic knees were affected more often than prosthetic hips (78%). Conclusions: During an episode of hematogenous PJI, concomitant asymptomatic prosthetic joints have a very low risk of being infected, and additional diagnostic work-up for these joints is not necessary.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Periprosthetic joint infection ; Late acute ; Hematogenous ; Asymptomatic ; Bacteremia
Publicat a:	Clinical Infectious Diseases, Vol. 73 Núm. 11 (january 2021) , p. E3820-E3824, ISSN 1537-6591

DOI: 10.1093/cid/ciaa1222
PMID: 32813012

5 p, 230.9 KB

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