Relationship of pathogenic bacteria distribution with drug resistance and treatment cycle for periprosthetic joint infection after total joint arthroplasty / 中国组织工程研究

ABSTRACT

BACKGROUND: Understanding the characteristics of bacteriology in periprosthetic joint infection and choosing specific anti-infective drugs are very important to control the periprosthetic joint infection. The results of bacterial culture and antimicrobial susceptibility test can provide important reference for diagnosis and treatment. OBJECTIVE: To investigate the distribution and drug resistance of pathogenic bacteria in periprosthetic joint infection patients, and analyze the effect of bacterial culture results on the treatment period. METHODS: A retrospective analysis was conducted on 59 patients who underwent artificial joint revision between September 2015 and September 2019. The infection time, results of bacterial culture and antimicrobial susceptibility test, antibiotics application duration, prosthesis-free interval, total length of hospital stay from infection to renovation, recovery time of erythrocyte sedimentation rate and C-reactive protein were collected. The pathogenic bacteria distribution, drug resistance situation and the effect of the pathogenic bacteria and bacterial resistance on antibiotics application duration, prosthesis-free interval, and days in hospital were analyzed. RESULTS AND CONCLUSION: (1) Among the 59 patients with periprosthetic joint infection, there were 31 cases of hip joint and 28 cases of knee joint. The highest proportion of periprosthetic joint infection phase was delayed infection (49%). The pathogenic bacteria were cultured from 35 cases, and the positive rate of bacterial culture was 59%. (2) Among the cultured pathogens, staphylococcus aureus accounted for the highest proportion (29%). (3) The pathogenic bacteria of 18 patients were antibiotic resistant, and the drug resistance rate reached 51%. (4) The bacterial cultured negative group had longer prosthesis-free interval and longer recovery times of erythrocyte sedimentation rate and C-reactive protein than those of the positive group (P < 0.05). (5) Compared with the group with sensitive antibiotics, the duration of antibiotic application and recovery times of erythrocyte sedimentation rate and C-reactive protein were longer in the group with resistant antibiotics (P < 0.05). (6) In this study, the positive rate of bacterial culture in periprosthetic joint infection patients was not high, but the resistance rate of pathogenic bacteria was relatively high; the treatment period with positive pathogenic bacteria and sensitive antibiotics was shorter.