Higher Risk of Failure of Methicillin-resistant Staphylococcus aureus Prosthetic Joint Infections
- 1 August 2007
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 461, 48-53
- https://doi.org/10.1097/blo.0b013e3181123d4e
Abstract
We determined the effect of methicillin resistance on the outcome of patients with Staphylococcus aureus prosthetic joint infections. From January 1995 to December 2004, 33% of 137 episodes of prosthetic joint infections were the result of S. aureus (in monomicrobial or polymicrobial cultures).Thirty-three (24%) episodes among 31 patients were the result of methicillin-susceptible S. aureus and 12 (9%) episodes among 12 patients were the result of methicillin-resistant S. aureus. Overall treatment failure rate was 38%. Patients with methicillin-susceptible S. aureus or methicillin-resistant S. aureus prosthetic joint infections did not differ in age, gender, comorbidities, joint age, prior surgical procedures performed on the affected joint, number of postsurgical medical complications, or duration of intravenous antimicrobial therapy. Patients with methicillin-resistant S. aureus prosthetic joint infection had longer hospital durations (median, 15 versus 10 days). Methicillin-resistant S. aureus in periprosthetic tissue culture resulted in a higher risk of treatment failure (hazard ratio, 9.2; 95% confidence interval, 2.40-35.46) than methicillin-susceptible S. aureus when controlling for joint location (total knee arthroplasty versus total hip arthroplasty [hazard ratio, 5.8; 95% confidence interval, 1.52-22.19]) and removal of hardware (hazard ratio, 0.24; 95% confidence interval, 0.077-0.75). Efforts should be made to prevent methicillin-resistant S. aureus infections of joint arthroplasties and develop new treatment modalities. Level of Evidence: Level II, retrospective prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.Keywords
This publication has 25 references indexed in Scilit:
- Conservative Treatment of Staphylococcal Prosthetic Joint Infections in Elderly PatientsAmerican Journal Of Medicine, 2006
- Outcome of Prosthetic Joint Infection in Patients with Rheumatoid Arthritis: The Impact of Medical and Surgical Therapy in 200 EpisodesClinical Infectious Diseases, 2006
- The Impact of Methicillin Resistance in Staphylococcus aureus Bacteremia on Patient Outcomes: Mortality, Length of Stay, and Hospital ChargesInfection Control & Hospital Epidemiology, 2005
- Adverse Clinical and Economic Outcomes Attributable to Methicillin Resistance among Patients withStaphylococcus aureusSurgical Site InfectionClinical Infectious Diseases, 2003
- Emerging Antibiotic-Resistant BacteriaClinical Orthopaedics and Related Research, 1999
- Staphylococcus aureus Prosthetic Joint Infection Treated With Prosthesis Removal and Delayed Reimplantation ArthroplastyMayo Clinic Proceedings, 1999
- Nosocomial Methicillin-Resistant and Methicillin-SusceptibleStaphylococcus AureusPrimary Bacteremia: At What Costs?Infection Control & Hospital Epidemiology, 1999
- Staphylococcus aureus Prosthetic Joint Infection Treated with Debridement and Prosthesis RetentionClinical Infectious Diseases, 1997
- Modeling and variable selection in epidemiologic analysis.American Journal of Public Health, 1989
- Outcome of infected total hip arthroplasty: An inclusive, consecutive seriesThe Journal of Arthroplasty, 1988