[Microbiological characteristics and patterns of resistance in prosthetic joint infections in a referral hospital]

Cir Cir. 2015 Sep-Oct;83(5):371-7. doi: 10.1016/j.circir.2015.05.030. Epub 2015 Jul 2.
[Article in Spanish]

Abstract

Background: The prosthetic joint infection is the most feared and catastrophic complication for cause severe physical damage to patients and, generates high economic costs.

Objectives: To describe the microbiological characteristics and to determine the resistance pattern in prosthetic joint infections in a reference hospital in Mexico.

Material and methods: Patients whose prosthetic devices were withdrawn due to suspicion of septic and aseptic loosening were included. Cultures were performed to identify microorganisms and susceptibility analysis.

Results: Of the 111 patients included, 55% were diagnosed with prosthetic joint infection, with the most frequent prosthesis being of the hip (43%). Positive cultures were obtained in 97% of the infected cases, of which 75% were monomicrobial infections. The most frequent bacterial species isolated were: Staphylococcus epidermidis (31%), Enterococcus faecalis (16%), Staphylococcus aureus (13%), and Escherichia coli (8%). The resistance patterns for the Staphylococcus genus were: oxacillin (79%), erythromycin (45%) and ciprofloxacin (37%). Enterococcus faecalis showed a high percentage of resistance to erythromycin and clindamycin (86%), and fluoroquinolones (43%). The large majority (86%) of Escherichia coli were extended spectrum beta-lactamases positive, in addition to having high resistance to fluoroquinolones (86%), trimethoprim/sulfamethoxazole (86%) and gentamicin (72%).

Conclusion: The microbiological characteristics found in prosthetic joint infections vary according to the hospitals. In this series, a high proportion of coagulase-negative Staphylococci and Enterococcus spp. were found, as well as a high bacterial resistance.

Keywords: Infección; Infection; Microbial resistance; Microorganismos; Microorganisms; Prosthetic joint; Prótesis articular; Resistencia microbiana.

Publication types

  • English Abstract
  • Observational Study

MeSH terms

  • Academies and Institutes / statistics & numerical data
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Cross-Sectional Studies
  • Device Removal
  • Drug Resistance, Multiple, Bacterial*
  • Drug Resistance, Multiple, Fungal
  • Elbow Prosthesis / adverse effects*
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / microbiology
  • Female
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / microbiology
  • Hip Prosthesis / adverse effects*
  • Humans
  • Knee Prosthesis / adverse effects*
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Mycoses / epidemiology
  • Mycoses / microbiology
  • Prosthesis Failure / etiology
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / microbiology*
  • Rehabilitation Centers / statistics & numerical data
  • Tertiary Care Centers / statistics & numerical data

Substances

  • Anti-Bacterial Agents