Microbiology Alloplastic Total Joint Infections: A 20-Year Retrospective Study
| Autor: | Gino Inverso, Peter D. Quinn, Kevin Sweeney, Eric J. Granquist, Rhae Riegel |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Staphylococcus aureus Prosthesis-Related Infections medicine.drug_class medicine.medical_treatment Joint Prosthesis Antibiotics Prosthesis 03 medical and health sciences Propionibacterium acnes 0302 clinical medicine Internal medicine Medicine Humans 030212 general & internal medicine Device Removal Aged Retrospective Studies Aged 80 and over biology business.industry Retrospective cohort study 030206 dentistry Perioperative Middle Aged Temporomandibular Joint Disorders biology.organism_classification Antibiotic coverage Anti-Bacterial Agents Treatment Outcome Otorhinolaryngology Current Procedural Terminology Vancomycin Surgery Female Oral Surgery business medicine.drug |
| Zdroj: | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 76(2) |
| ISSN: | 1531-5053 |
| Popis: | Purpose Prosthetic joint infection (PJI) is a rare complication of temporomandibular joint replacement (TJR). This study evaluated TJR PJIs at the authors' institution over a 20-year period, including micro-organisms cultured, antibiotic resistance patterns, and intraoperative protocols of TJR. Patients and Methods Patients were identified using Current Procedural Terminology and International Classification of Diseases, Ninth Revision codes and surgical logs from January 1995 through 2015. Inclusion criteria were adults older than 18 years with previous alloplastic TJR and the presence of infection of the prosthesis at explantation. Exclusion criteria were patients younger than 18 years and who received hemiarthroplasty. Primary outcomes included culture data and antibiotic selection for PJI. Secondary outcomes included intraoperative duration and in vivo duration. Results Eleven patients were identified and 15 joints were explanted. Average length in vivo was 232 months (standard deviation, 478.9 months). Six percent (n = 1) were identified as early PJI (0 to 3 months), 46% (n = 7) were intermediate PJI (3 months to 2 yr), and 33% (n = 5) were late PJI (>2 yr). One patient could not be classified as early, intermediate, or late. Staphylococcus aureus was present in 53% of patients and was the predominant organism isolated. Propionibacterium acnes was isolated in 33% of patients. Penicillin was the antibiotic with the greatest organism resistance (46%). Conclusion In the present study, the most commonly cultured organism was S aureus (53%), a finding consistent with current literature. The prevalence of P acnes colonization was noted in 33% of cases. Although the relevance of P acnes and its contribution to PJI requires further investigation, it is associated with PJI and biofilm formation. Based on this study, consideration could be given to the use of vancomycin and first-generation cephalosporins as perioperative antibiotic coverage. |
| Databáze: | OpenAIRE |
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