Trends in Microbiological Spectrum and Antibiotic Resistance Pattern in Periprosthetic Joint Infections

Activity: Talk or presentation types › Oral presentation

Description

Periprosthetic joint infections is one of the most devastating complication after total joint arthroplasty (PJI). We sought to characterise the causative pathogens of PJI, and to evaluate trends in the microbial aetiology.. Over a ten-year period, hip and knee PJI patients treated at the Hospital of Traumatology and orthopaedics (Latvia, Riga), were retrospectively included. We divided this period into two 5-year intervals (2013-2017 and 2018-2022). The demographic characteristics, causative pathogens and antimicrobial susceptibility, time of infection, site of arthroplasty were recorded. . A total of 449 first-time infection cases (263 hip PJIs and 186 knee PJIs) from January 2013 to December 2022 were included in the retrospective study. A microbiological diagnosis was obtained for 400 cases (89%). In all, 6,2% of all episodes (28) were polymicrobial. The main pathogens were gram-positive cocci, accounting for 65% of the isolates, and the most common pathogen was S.aureus, accounting 31,8% (n=143) of the isolates, followed by coagulase-negative staphylococci (n=89; 19,8%). The distribution of these microorganisms slightly differ between the two study periods (S.aureus: 27,9% in 2013-2017, 34,2% in 2018-2022; coagulase-negative staphylococci 22,7% in 2013-2017, 18,6% in 2018-2022). Gram-negative bacilli accounted for 10,6% of the isolates (8,7% in 2013-2017, 12% in 2018-2022), fungi accounted only for 0,6% (n=3). Multidrug resistant bacteria were involved in 25 (5,5%) PJIs during the study period, including 4 methicillin resistant staphylococcus aureus, 20 multidrug resistant Gram negative bacilli and 1 vancomycin resistant enterococcus. The proportion of PJI caused by multidrug-resistant bacteria increased from 2,8 (n=6) in 2013-2017 till 6,2% (n=15) in 2018-2022.. The distribution of microorganisms was not significantly different between the two periods. The exception is the increase in the proportion of multiresistant microorganisms, mainly due to the increase in resistant Gram negative microorganisms. The observed trends have significant implications for prescribing empiric therapy for acute PJIs.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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