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Frequency of haematogenous periprosthetic joint infection due to bacteraemia caused by gram-positive cocci

Thompson, Olof LU and Påhlman, Lisa LU (2025) In Infectious Diseases
Abstract
Background
Presence of a prosthetic joint entails a life-long risk of haematogenous periprosthetic joint infection (hPJI) during bacteraemia. For bacteraemia with Staphylococcus aureus the hPJI frequency has been described to be up to 40% and for streptococci up to 20%, with large variation among reported frequencies.
Objectives
We aimed to investigate the hPJI frequency from bacteraemia with virulent gram-positive cocci in patients with hip and/or knee prosthesis.
Methods
A population and register based approach was used. Through cross-matching of blood cultures positive for virulent gram-positive cocci and data from the Swedish Arthroplasty Register, patients with at least one prosthesis in place during bacteraemia... (More)
Background
Presence of a prosthetic joint entails a life-long risk of haematogenous periprosthetic joint infection (hPJI) during bacteraemia. For bacteraemia with Staphylococcus aureus the hPJI frequency has been described to be up to 40% and for streptococci up to 20%, with large variation among reported frequencies.
Objectives
We aimed to investigate the hPJI frequency from bacteraemia with virulent gram-positive cocci in patients with hip and/or knee prosthesis.
Methods
A population and register based approach was used. Through cross-matching of blood cultures positive for virulent gram-positive cocci and data from the Swedish Arthroplasty Register, patients with at least one prosthesis in place during bacteraemia were identified. Medical records were reviewed if patients had concordant microbiological cultures in blood and synovial fluid, tissue or bone, to determine if hPJI was present. Absence of concordant cultures was interpreted as absence of hPJI.
Results
Of all 2392 episodes of bacteraemia identified during the study period, 143 (6%) caused at least one hPJI. The highest frequency of hPJI was observed for S. aureus (9.6%) and Streptococcus agalactiae (9.3%). Increasing number of prostheses in place, male sex and lower age were independently associated with hPJI. Bacteraemia with other species than S. aureus or S. agalactiae was associated with a lower hPJI risk.
Conclusion
The observational risk of hPJI from bacteraemia with virulent gram-positive cocci was much lower than in previous reports, especially for S. aureus, with an hPJI frequency of 9.6%. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Infectious Diseases
publisher
Taylor & Francis
external identifiers
  • pmid:40080629
  • scopus:105000351012
ISSN
2374-4243
DOI
10.1080/23744235.2025.2476530
language
English
LU publication?
yes
id
e15903b0-4097-4857-9365-1e012d301db6
date added to LUP
2025-05-01 10:47:56
date last changed
2025-05-05 08:07:54
@article{e15903b0-4097-4857-9365-1e012d301db6,
  abstract     = {{Background<br/>Presence of a prosthetic joint entails a life-long risk of haematogenous periprosthetic joint infection (hPJI) during bacteraemia. For bacteraemia with Staphylococcus aureus the hPJI frequency has been described to be up to 40% and for streptococci up to 20%, with large variation among reported frequencies.<br/>Objectives<br/>We aimed to investigate the hPJI frequency from bacteraemia with virulent gram-positive cocci in patients with hip and/or knee prosthesis.<br/>Methods<br/>A population and register based approach was used. Through cross-matching of blood cultures positive for virulent gram-positive cocci and data from the Swedish Arthroplasty Register, patients with at least one prosthesis in place during bacteraemia were identified. Medical records were reviewed if patients had concordant microbiological cultures in blood and synovial fluid, tissue or bone, to determine if hPJI was present. Absence of concordant cultures was interpreted as absence of hPJI.<br/>Results<br/>Of all 2392 episodes of bacteraemia identified during the study period, 143 (6%) caused at least one hPJI. The highest frequency of hPJI was observed for S. aureus (9.6%) and Streptococcus agalactiae (9.3%). Increasing number of prostheses in place, male sex and lower age were independently associated with hPJI. Bacteraemia with other species than S. aureus or S. agalactiae was associated with a lower hPJI risk.<br/>Conclusion<br/>The observational risk of hPJI from bacteraemia with virulent gram-positive cocci was much lower than in previous reports, especially for S. aureus, with an hPJI frequency of 9.6%.}},
  author       = {{Thompson, Olof and Påhlman, Lisa}},
  issn         = {{2374-4243}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Taylor & Francis}},
  series       = {{Infectious Diseases}},
  title        = {{Frequency of haematogenous periprosthetic joint infection due to bacteraemia caused by gram-positive cocci}},
  url          = {{http://dx.doi.org/10.1080/23744235.2025.2476530}},
  doi          = {{10.1080/23744235.2025.2476530}},
  year         = {{2025}},
}