Outcome of group B streptococcal prosthetic hip infections compared to that of other bacterial infections

Joint Bone Spine. 2009 Oct;76(5):491-6. doi: 10.1016/j.jbspin.2008.11.010. Epub 2009 Jun 13.

Abstract

Background: Outcome of streptococcal prosthetic hip infection is often thought to be better than that caused by other pathogens. That supposition was not confirmed in our experience with group B streptococcal prosthetic joint infection.

Objective: We compared outcomes of group B streptococcal and other-pathogen prosthetic hip infections.

Methods: One hundred and thirty nine patients, 24 with group B streptococcal and 115 other-pathogen prosthetic hip infections, were included. The primary outcome was the time from surgical treatment to treatment failure, defined as relapse, infection- or treatment-related death. Secondary outcomes were the times from surgical treatment to relapse or any event (event-free survival). The cumulative incidence estimator was used to model primary and secondary outcomes. Multivariable regression analysis was used to determine a set of independent predictors of treatment failure.

Results: With a median follow-up of 22 months, treatment failed more frequently in patients with group B streptococcal prosthetic hip infections (hazard ratio, 4.88 [95% CI, 1.4-17], P=.012). Multivariable analysis retained the American Society of Anesthesiologist score and group B streptococcal infection as independent risk factors of treatment failure; event-free survival was lower for these patients (hazard ratio, 2.64 [95% CI, 1.2-6], P=.02).

Conclusion: Despite high antibiotic susceptibility, outcomes of group B streptococcal and other-pathogen prosthetic hip infection differ.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / drug therapy
  • Bacterial Infections / epidemiology*
  • Female
  • Follow-Up Studies
  • Hip Prosthesis / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / drug therapy
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / microbiology
  • Proportional Hazards Models
  • Prosthesis Failure
  • Regression Analysis
  • Reoperation / statistics & numerical data
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / epidemiology*
  • Streptococcus agalactiae*
  • Time Factors
  • Treatment Failure
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents