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Analysis of causative microorganism in 248 primary hip arthroplasties revised for infection: a study using the NJR dataset

Lookup NU author(s): Dr Richard Holleyman, Paul Baker, Professor David Deehan

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Abstract

Introduction: This study aimed to describe the epidemiology of the causative organism in a series of primary hip arthroplasties revised for a diagnosis of periprosthetic joint infection (PJI) in England and Wales.Methods: Patient data from the National Joint Registry (NJR) was linked to microbiology data held by Public Health England (PHE) which identified a series of 248 primary hip arthroplasties revised for PJI between 2003 and 2014. Definitive cultures, isolated at time of revision surgery, were available for all cases. Total hip arthroplasty (n = 239, 96%) and hip resurfacing (n = 5, 2%) were the most commonly performed primary procedures. A two-stage revision was the most common operative management (n = 174, 70%).Results: 202 (81%) cases were infected with a single genus microorganism and the most commonly implicated genus was Staphylococcus species (70% of all single genus infections). Staphylococcus species were also the most commonly identified microorganism in mixed genus infections (74% of patient's cultures). There was a significant difference in microorganism distribution when comparing uncemented vs cement implant fixation, with a higher incidence of Gram-negative infection observed in the uncemented group (p = 0.048, Chi-square).Conclusions: Both prophylactic and therapeutic antibiotic regimes should be focused on targeting Staphylococci.


Publication metadata

Author(s): Holleyman RJ, Baker PN, Charlett A, Gould K, Deehan DJ

Publication type: Article

Publication status: Published

Journal: HIP International

Year: 2016

Volume: 26

Issue: 1

Pages: 82-89

Print publication date: 08/02/2016

Online publication date: 27/01/2016

Acceptance date: 22/09/2015

ISSN (print): 1120-7000

ISSN (electronic): 1724-6067

Publisher: Wichtig Publishing

URL: http://dx.doi.org/10.5301/hipint.5000313

DOI: 10.5301/hipint.5000313


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