IR@PKUHSC  > 北京大学第二临床医学院
学科主题临床医学
Identifying Common Pathogens in Periprosthetic Joint Infection and Testing Drug-resistance Rate for Different Antibiotics: A Prospective, Single Center Study in Beijing
Li, Zhang-lai1,2; Hou, Yun-fei2; Zhang, Bao-qing2,4; Chen, Yi-fan2; Wang, Qi3; Wang, Kai2; Chen, Zhao-yu2; Li, Xiao-wei2; Lin, Jian-hao2
通讯作者Lin, Jian-hao(2)
关键词Drug-resistance Pathogen Periprosthetic joint infection
刊名ORTHOPAEDIC SURGERY
2018-08-01
DOI10.1111/os.12394
10期:3页:235-240
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Orthopedics
研究领域[WOS]Orthopedics
关键词[WOS]LOW-GRADE INFECTION ; TOTAL HIP-ARTHROPLASTY ; REVISION TOTAL HIP ; KNEE ARTHROPLASTY ; UNITED-STATES ; DIAGNOSIS ; MANAGEMENT ; EPIDEMIOLOGY ; REPLACEMENT ; PROJECTIONS
英文摘要

Objective: The aim of this study is to identify the common microorganisms causing PJI as well as the drug-resistant spectrum for each microorganism, to help orthopaedic surgeons to choose appropriate antibiotics.

Method: One hundred and sixty patients who suffered from failure of primary or revision total hip or knee arthroplasty for different reasons were prospectively recruited. These patients underwent revision or re-revision total hip or knee arthroplasty in our institution between August 2013 to August 2016. The details of patients′ medical history and comprehensive physical examination, as well as demographic data were recorded precisely. Routine blood test results, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) levels, and synovial leukocyte counts were collected. Additionally, aspiration was conducted during surgery to avoid pollution unless when PJI was strongly suspected, in which case, joint puncture and aspiration were conducted before surgery. Intraoperatively, the implant-surrounding tissue and the prosthesis were collected under aseptic conditions. Postoperatively, the prosthesis, implant-surrounding tissue and synovium were sent to the laboratory immediately. The sonicate extraction (the prosthesis was sent for ultrasound sonication first), implant surrounding tissue and synovium were sent for microbiologic culture, and the implant-surrounding tissue was also sent for pathological examination. The isolated bacteria strains and drug-resistance rates for each pathogen for different antibiotics were presented.

Results: There were 59 PJI cases in the infectious group and 101 cases in the non-infectious group (PJI is diagnosed according to the diagnosing criteria from the Workgroup of the Musculoskeletal Infection Society). Of 69 strains of pathogens isolated, Gram-positive bacterium is the most common pathogenic bacteria causing PJI (60, 86.96%). Staphylococcus epidermidis and Staphylococcus aureus played an important role as well, followed by Gram-negative bacteria (8, 11.59%) and fungus (1, 1.45%). Penicillin (78.57%), erythromycin (66.67%) and clindamycin (44.74%) showed high antibiotic resistance rate. In addition, the second-generation cephalosporin, usually as the prophylactic antibiotic, resistance rate was high (20%) as well. Fortunately, no vancomycin-resistant bacteria were discovered in the current study.

Conclusion: This study provides some information on the most common pathogens in our institution and the selection of antibiotics in the perioperative period in northern China. Cefuroxime and clindamycin might not be appropriate for use as prophylactic antibiotics in revision total knee or hip arthroplasty. Vancomycin is ideal for empiric antibiotic use in suspected PJI cases because of the low drug-resistance rate.

语种英语
WOS记录号WOS:000442852700009
通讯作者邮箱li_pku@foxmail.com
第一作者单位Xiamen Univ, Dept Orthoped, Fuzhou Hosp 2, Fuzhou, Fujian, Peoples R China ; Peking Univ, Arthrit Clin & Res Ctr, Peoples Hosp, Beijing 100044, Peoples R China
通讯作者单位Peking Univ, Arthrit Clin & Res Ctr, Peoples Hosp, Beijing 100044, Peoples R China
ISSN1757-7853
引用统计
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/143000
专题北京大学第二临床医学院
北京大学第二临床医学院_骨关节科
北京大学第三临床医学院_护理部
作者单位1.Xiamen Univ, Dept Orthoped, Fuzhou Hosp 2, Fuzhou, Fujian, Peoples R China;
2.Peking Univ, Arthrit Clin & Res Ctr, Peoples Hosp, Beijing 100044, Peoples R China;
3.Peking Univ, Dept Clin Lab, Peoples Hosp, Beijing, Peoples R China;
4.Shandong Univ, Dept Orthoped, Qilu Hosp, Jinan, Shandong, Peoples R China
推荐引用方式
GB/T 7714
Li, Zhang-lai,Hou, Yun-fei,Zhang, Bao-qing,et al. Identifying Common Pathogens in Periprosthetic Joint Infection and Testing Drug-resistance Rate for Different Antibiotics: A Prospective, Single Center Study in Beijing[J]. ORTHOPAEDIC SURGERY,2018,10(3):235-240.
APA Li, Zhang-lai.,Hou, Yun-fei.,Zhang, Bao-qing.,Chen, Yi-fan.,Wang, Qi.,...&Lin, Jian-hao.(2018).Identifying Common Pathogens in Periprosthetic Joint Infection and Testing Drug-resistance Rate for Different Antibiotics: A Prospective, Single Center Study in Beijing.ORTHOPAEDIC SURGERY,10(3),235-240.
MLA Li, Zhang-lai,et al."Identifying Common Pathogens in Periprosthetic Joint Infection and Testing Drug-resistance Rate for Different Antibiotics: A Prospective, Single Center Study in Beijing".ORTHOPAEDIC SURGERY 10.3(2018):235-240.
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