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Group B streptococcus in prosthetic hip and knee joint-associated infections

Sendi, P.; Christensson, Bertil LU ; Uckay, I.; Trampuz, A.; Achermann, Y.; Boggian, K.; Svensson, D; Widerstrom, M. and Zimmerli, W. (2011) In Journal of Hospital Infection 79(1). p.64-69
Abstract
The incidence of invasive group B streptococcus (GBS) infections in non-pregnant adults is increasing. Little is known about GBS in periprosthetic joint infections (PJIs). We aimed to analyse the clinical presentation of GBS PJI and its treatment in association with the outcome. The characteristics of 36 GBS PJIs collected from 10 centres were investigated. In 34 episodes, follow-up examination of >= 2 years was available, allowing treatment and outcome analysis. Most infections (75%) occurred >= 3 months after implantation. Most patients (91%) had at least one comorbidity; 69% presented with acute symptoms and 83% with damaged periprosthetic soft tissue. In 20 of 34 episodes debridement and retention of implant was attempted, but in... (More)
The incidence of invasive group B streptococcus (GBS) infections in non-pregnant adults is increasing. Little is known about GBS in periprosthetic joint infections (PJIs). We aimed to analyse the clinical presentation of GBS PJI and its treatment in association with the outcome. The characteristics of 36 GBS PJIs collected from 10 centres were investigated. In 34 episodes, follow-up examination of >= 2 years was available, allowing treatment and outcome analysis. Most infections (75%) occurred >= 3 months after implantation. Most patients (91%) had at least one comorbidity; 69% presented with acute symptoms and 83% with damaged periprosthetic soft tissue. In 20 of 34 episodes debridement and retention of implant was attempted, but in five of these the prosthesis was ultimately removed. Hence, in 19 (56%) episodes, the implant was removed, including 14 immediate removals. In four episodes the removal was permanent. Penicillin derivatives and clindamycin were the most common antimicrobials administered (68%). In 94% the infection was cured, and in 82% functional mobility preserved. Debridement with implant retention was successful if the duration of symptoms was short, the prosthesis stable, and the tissue damage minor (10/10 vs 3/10 episodes, P = 0.003). Surgery that complied with a published algorithm was associated with a favourable outcome (P = 0.049). (C) 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Group B streptococcus, Prosthesis-related infections, Streptococcus
in
Journal of Hospital Infection
volume
79
issue
1
pages
64 - 69
publisher
Elsevier
external identifiers
  • wos:000293781800014
  • scopus:80051474746
ISSN
0195-6701
DOI
10.1016/j.jhin.2011.04.022
language
English
LU publication?
yes
id
99b0cc98-82ac-4a82-8de5-375dbaf1cdc5 (old id 2161939)
date added to LUP
2011-10-03 08:35:37
date last changed
2017-07-09 03:49:14
@article{99b0cc98-82ac-4a82-8de5-375dbaf1cdc5,
  abstract     = {The incidence of invasive group B streptococcus (GBS) infections in non-pregnant adults is increasing. Little is known about GBS in periprosthetic joint infections (PJIs). We aimed to analyse the clinical presentation of GBS PJI and its treatment in association with the outcome. The characteristics of 36 GBS PJIs collected from 10 centres were investigated. In 34 episodes, follow-up examination of >= 2 years was available, allowing treatment and outcome analysis. Most infections (75%) occurred >= 3 months after implantation. Most patients (91%) had at least one comorbidity; 69% presented with acute symptoms and 83% with damaged periprosthetic soft tissue. In 20 of 34 episodes debridement and retention of implant was attempted, but in five of these the prosthesis was ultimately removed. Hence, in 19 (56%) episodes, the implant was removed, including 14 immediate removals. In four episodes the removal was permanent. Penicillin derivatives and clindamycin were the most common antimicrobials administered (68%). In 94% the infection was cured, and in 82% functional mobility preserved. Debridement with implant retention was successful if the duration of symptoms was short, the prosthesis stable, and the tissue damage minor (10/10 vs 3/10 episodes, P = 0.003). Surgery that complied with a published algorithm was associated with a favourable outcome (P = 0.049). (C) 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.},
  author       = {Sendi, P. and Christensson, Bertil and Uckay, I. and Trampuz, A. and Achermann, Y. and Boggian, K. and Svensson, D and Widerstrom, M. and Zimmerli, W.},
  issn         = {0195-6701},
  keyword      = {Group B streptococcus,Prosthesis-related infections,Streptococcus},
  language     = {eng},
  number       = {1},
  pages        = {64--69},
  publisher    = {Elsevier},
  series       = {Journal of Hospital Infection},
  title        = {Group B streptococcus in prosthetic hip and knee joint-associated infections},
  url          = {http://dx.doi.org/10.1016/j.jhin.2011.04.022},
  volume       = {79},
  year         = {2011},
}