Streptococcal and Staphylococcus aureus prosthetic joint infections: are they really different?
Anti-Bacterial Agents
/ therapeutic use
Arthritis, Infectious
/ drug therapy
Cohort Studies
Debridement
Humans
Prospective Studies
Prostheses and Implants
Prosthesis-Related Infections
/ surgery
Retrospective Studies
Staphylococcal Infections
/ drug therapy
Staphylococcus aureus
Streptococcus
/ genetics
Treatment Outcome
Methicillin-susceptible Staphylococcus aureus
Prosthetic joint infection
Streptococcus spp
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
17 Jun 2022
17 Jun 2022
Historique:
received:
14
02
2022
accepted:
10
06
2022
entrez:
17
6
2022
pubmed:
18
6
2022
medline:
22
6
2022
Statut:
epublish
Résumé
Staphylococci and streptococci are the most frequent pathogens isolated from prosthetic joint infections (PJIs). The aim of this study was to analyze the outcome of streptococcal and methicillin-susceptible Staphylococcus aureus (MSSA) PJIs. All monomicrobial streptococcal and MSSA PJIs managed in a French Referral Center (2010-2017) were sampled from the prospective PJIs cohort study. The primary outcome of interest was the cumulative reinfection-free survival at a 2-year follow-up. Two hundred and nine patients with 91 streptococcal and 132 staphylococcal infections were analyzed. Patients with streptococcal PJI were older, and infection was more frequently hematogenous. Reinfection-free survival rates at 2-years after all treatment strategies were higher for patients with streptococcal PJI (91% vs 81%; P = .012), but differed according to the strategy. After exchange arthroplasty, no outcome differences were observed (89% vs 93%; P = .878); after debridement, antibiotics and implant retention (DAIR), the reinfection-free survival rate was higher for patients with streptococcal PJI (87% vs 60%; P = .062). For patients managed with prolonged suppressive antibiotic therapy (SAT) alone, those with streptococcal PJIs had a 100% infection-free survival (100% vs 31%; P < .0001). Reinfection-free survival after DAIR and SAT was better for patients with streptococcal than those with MSSA PJIs. No difference was observed after prosthesis exchange.
Sections du résumé
BACKGROUND
BACKGROUND
Staphylococci and streptococci are the most frequent pathogens isolated from prosthetic joint infections (PJIs). The aim of this study was to analyze the outcome of streptococcal and methicillin-susceptible Staphylococcus aureus (MSSA) PJIs.
METHODS
METHODS
All monomicrobial streptococcal and MSSA PJIs managed in a French Referral Center (2010-2017) were sampled from the prospective PJIs cohort study. The primary outcome of interest was the cumulative reinfection-free survival at a 2-year follow-up.
RESULTS
RESULTS
Two hundred and nine patients with 91 streptococcal and 132 staphylococcal infections were analyzed. Patients with streptococcal PJI were older, and infection was more frequently hematogenous. Reinfection-free survival rates at 2-years after all treatment strategies were higher for patients with streptococcal PJI (91% vs 81%; P = .012), but differed according to the strategy. After exchange arthroplasty, no outcome differences were observed (89% vs 93%; P = .878); after debridement, antibiotics and implant retention (DAIR), the reinfection-free survival rate was higher for patients with streptococcal PJI (87% vs 60%; P = .062). For patients managed with prolonged suppressive antibiotic therapy (SAT) alone, those with streptococcal PJIs had a 100% infection-free survival (100% vs 31%; P < .0001).
CONCLUSIONS
CONCLUSIONS
Reinfection-free survival after DAIR and SAT was better for patients with streptococcal than those with MSSA PJIs. No difference was observed after prosthesis exchange.
Identifiants
pubmed: 35715754
doi: 10.1186/s12879-022-07532-x
pii: 10.1186/s12879-022-07532-x
pmc: PMC9206280
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
555Informations de copyright
© 2022. The Author(s).
Références
Front Cell Infect Microbiol. 2015 Apr 08;5:31
pubmed: 25905046
Clin Microbiol Infect. 2016 Aug;22(8):732.e1-8
pubmed: 27181408
Infect Dis Clin North Am. 2017 Jun;31(2):237-252
pubmed: 28366224
Clin Infect Dis. 2006 Oct 15;43(8):968-70
pubmed: 16983606
J Infect. 2018 Apr;76(4):328-334
pubmed: 29395369
Int J Med Microbiol. 2014 Jul;304(5-6):565-76
pubmed: 24768432
New Microbes New Infect. 2016 Apr 13;12:8-17
pubmed: 27222712
Orthop Traumatol Surg Res. 2019 Feb;105(1):185-190
pubmed: 30413338
J Arthroplasty. 2018 Oct;33(10):3238-3245
pubmed: 29914821
J Infect. 2019 Sep;79(3):199-205
pubmed: 31319141
Bone Joint J. 2019 Jan;101-B(1_Supple_A):19-24
pubmed: 30648487
Antimicrob Agents Chemother. 2009 Mar;53(3):883-7
pubmed: 19075069
Eur J Clin Microbiol Infect Dis. 2017 Sep;36(9):1679-1684
pubmed: 28447173
Clin Infect Dis. 2006 Oct 15;43(8):961-7
pubmed: 16983605
Clin Orthop Relat Res. 2013 Oct;471(10):3214-22
pubmed: 23775569
J Arthroplasty. 2008 Oct;23(7):984-91
pubmed: 18534466
J Arthroplasty. 2014 Mar;29(3):469-72
pubmed: 23998990
Int J Antimicrob Agents. 2016 Sep;48(3):310-6
pubmed: 27524103
Antibiotics (Basel). 2022 Apr 05;11(4):
pubmed: 35453237
Clin Microbiol Infect. 2010 Dec;16(12):1789-95
pubmed: 21077986
Clin Infect Dis. 2013 Jan;56(2):182-94
pubmed: 22942204
Infect Immun. 2014 Mar;82(3):1141-6
pubmed: 24371220
Eur J Clin Microbiol Infect Dis. 2018 Oct;37(10):1949-1956
pubmed: 30083889
BMC Infect Dis. 2016 Oct 13;16(1):568
pubmed: 27737642
Clin Microbiol Infect. 2019 Mar;25(3):353-358
pubmed: 29803842
Int Orthop. 2015 Mar;39(3):397-401
pubmed: 25183296
J Bone Joint Surg Am. 2014 Jan 1;96(1):e1
pubmed: 24382729
Front Cell Infect Microbiol. 2015 Feb 04;5:6
pubmed: 25699242
J Antimicrob Chemother. 2009 Jun;63(6):1264-71
pubmed: 19336454
Int Orthop. 2013 Aug;37(8):1471-5
pubmed: 23695880
Int J Infect Dis. 2019 Aug;85:175-181
pubmed: 31212103
Clin Infect Dis. 2017 Jun 15;64(12):1742-1752
pubmed: 28369296
Enferm Infecc Microbiol Clin. 2017 Mar;35(3):189-195
pubmed: 28215487
J Intern Med. 2014 Aug;276(2):111-9
pubmed: 24605880
Clin Infect Dis. 2013 Jan;56(1):e1-e25
pubmed: 23223583