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Microbiology of the infected knee arthroplasty: Report from the Swedish Knee Arthroplasty Register on 426 surgically revised cases.

Stefansdottir, Anna LU ; Johansson, Daniel LU ; Knutson, Kaj LU ; Lidgren, Lars LU and Robertsson, Otto LU (2009) In Scandinavian Journal of Infectious Diseases 41(11-12). p.831-840
Abstract
Surgically revised deep infected primary knee arthroplasties reported to the Swedish knee arthroplasty register during the years 1986-2000 were studied with respect to microbiology, antimicrobial susceptibility pattern and changes over time. In early, delayed and late infections, coagulase-negative staphylococci (CoNS) were most prevalent (105/299, 35.1%), and twice as common as Staphylococcus aureus (55/299, 18.4%). In haematogenous infections, S. aureus was the dominating pathogen (67/99, 67.7%), followed by streptococci and Gram-negative bacteria. Methicillin resistance was found in 1/84 tested isolates of S. aureus and 62/100 tested isolates of CoNS. During the study period, methicillin resistance among CoNS increased (p=0.002).... (More)
Surgically revised deep infected primary knee arthroplasties reported to the Swedish knee arthroplasty register during the years 1986-2000 were studied with respect to microbiology, antimicrobial susceptibility pattern and changes over time. In early, delayed and late infections, coagulase-negative staphylococci (CoNS) were most prevalent (105/299, 35.1%), and twice as common as Staphylococcus aureus (55/299, 18.4%). In haematogenous infections, S. aureus was the dominating pathogen (67/99, 67.7%), followed by streptococci and Gram-negative bacteria. Methicillin resistance was found in 1/84 tested isolates of S. aureus and 62/100 tested isolates of CoNS. During the study period, methicillin resistance among CoNS increased (p=0.002). Gentamicin resistance was found in 1/28 tested isolates of S. aureus and 19/29 tested CoNS isolates. A relative decrease in infections caused by S. aureus was observed, while enterococci increased. In empiric treatment of infected knee arthroplasty the type of infection should direct the choice of antibiotics. Awareness of the fact that most early infections are caused by CoNS can increase the chances of successful treatment with retained implant. Due to the high rate of gentamicin resistance among CoNS in infected knee arthroplasty, other antibiotics should be used in bone cement at revision. (Less)
Please use this url to cite or link to this publication:
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organization
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type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Infectious Diseases
volume
41
issue
11-12
pages
831 - 840
publisher
Informa Healthcare
external identifiers
  • wos:000272974600005
  • pmid:19701856
  • scopus:70450164233
ISSN
1651-1980
DOI
10.1080/00365540903186207
language
English
LU publication?
yes
id
a91c0830-42c0-4d2a-99d3-ab75b1dba512 (old id 1469443)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19701856?dopt=Abstract
date added to LUP
2009-09-07 14:52:43
date last changed
2017-12-10 04:00:40
@article{a91c0830-42c0-4d2a-99d3-ab75b1dba512,
  abstract     = {Surgically revised deep infected primary knee arthroplasties reported to the Swedish knee arthroplasty register during the years 1986-2000 were studied with respect to microbiology, antimicrobial susceptibility pattern and changes over time. In early, delayed and late infections, coagulase-negative staphylococci (CoNS) were most prevalent (105/299, 35.1%), and twice as common as Staphylococcus aureus (55/299, 18.4%). In haematogenous infections, S. aureus was the dominating pathogen (67/99, 67.7%), followed by streptococci and Gram-negative bacteria. Methicillin resistance was found in 1/84 tested isolates of S. aureus and 62/100 tested isolates of CoNS. During the study period, methicillin resistance among CoNS increased (p=0.002). Gentamicin resistance was found in 1/28 tested isolates of S. aureus and 19/29 tested CoNS isolates. A relative decrease in infections caused by S. aureus was observed, while enterococci increased. In empiric treatment of infected knee arthroplasty the type of infection should direct the choice of antibiotics. Awareness of the fact that most early infections are caused by CoNS can increase the chances of successful treatment with retained implant. Due to the high rate of gentamicin resistance among CoNS in infected knee arthroplasty, other antibiotics should be used in bone cement at revision.},
  author       = {Stefansdottir, Anna and Johansson, Daniel and Knutson, Kaj and Lidgren, Lars and Robertsson, Otto},
  issn         = {1651-1980},
  language     = {eng},
  number       = {11-12},
  pages        = {831--840},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Infectious Diseases},
  title        = {Microbiology of the infected knee arthroplasty: Report from the Swedish Knee Arthroplasty Register on 426 surgically revised cases.},
  url          = {http://dx.doi.org/10.1080/00365540903186207},
  volume       = {41},
  year         = {2009},
}