Staphylococcal resistance profiles in deep infection following primary hip and knee arthroplasty: a study using the NJR dataset
| Autor: | Paul Baker, Andre Charlett, David J. Deehan, Julie Samuel, Mark D. F. Shirley, Lucy C Walker, Richard J. Holleyman |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis Prosthesis-Related Infections Revision medicine.medical_treatment Staphylococcus Arthroplasty Replacement Hip Resistance Periprosthetic Logistic regression Staphylococcal infections Arthroplasty 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Sensitivity Internal medicine Drug Resistance Bacterial medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Knee 030222 orthopedics business.industry 030229 sport sciences General Medicine Odds ratio Staphylococcal Infections medicine.disease Orthopaedic Surgery Anti-Bacterial Agents Orthopedic surgery Surgery business Infection |
| Zdroj: | Archives of Orthopaedic and Trauma Surgery |
| ISSN: | 1434-3916 0936-8051 |
| Popis: | Introduction This study aimed to (1) report the rates of resistance against a variety of antibiotics for pure Staphylococcal infections, and (2) examine the impact of ALBC use at primary surgery has on resistance patterns for patients undergoing first-time revision of primary hip and knee arthroplasty for indication of infection. Materials and methods Data from the National Joint Registry database for England and Wales were linked to microbiology data held by Public Health England to identify a consecutive series of 258 primary hip and knee arthroplasties performed between April 2003 and January 2014 that went on to have a revision for Staphylococcal deep periprosthetic infection. Multivariate binary logistic regression was used to study predictors of microorganism resistance to a range of antimicrobials. Results After adjusting for patient and surgical factors, multivariate analysis showed the use of gentamicin-loaded bone cement at the primary surgery was associated with a significant increase in the risk of Staphylococcal gentamicin resistance (odds ratio 8.341, 95% CI 2.297–30.292, p = 0.001) and methicillin resistance (odds ratio 3.870, 95% CI 1.319–11.359, p = 0.014) at revision for infection. Conclusions Clinicians must anticipate the possibility of antibiotic resistance to ALBC utilised at primary surgery. |
| Databáze: | OpenAIRE |
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