Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Dec;30(6):532-5.
doi: 10.1007/s00264-006-0125-8. Epub 2006 Aug 1.

The microbiology of infected hip arthroplasty

Imran Rafiq  1 , A K Gambhir, B M Wroblewski, P R Kay
Affiliations

The microbiology of infected hip arthroplasty

Imran Rafiq et al. Int Orthop. 2006 Dec.

Abstract
in English, French

Infection following joint replacement surgery although rare presents a challenging problem. Bacterial resistance to antibiotics is an emerging problem. We analysed the microbiology of 337 single-stage revisions for deep infection. Coagulase negative staphylococcus was found to be the predominant organism, although staphylococcus aureus is gaining importance. Gentamicin only provides cover for 64.1% of organisms. Resistance to this commonly used antibiotic prophylaxis is escalating. Fusidic acid and erythromycin provide improved cover. We would suggest on a microbiological basis that these antibiotics be considered for addition to acrylic bone cement. This will provide local antibiotic delivery when performing a revision for deep infection.

Les infections après prothèses articulaires sont un problème difficile à résoudre, d’autant que les résistances aux antibiotiques devienne de plus en plus marquées. Nous avons analysé la microbiologie de 337 révisions en même temps, pour infection profonde. Un staphylocoque coagulase négatif a été trouvé comme micro-organisme prédominant bien que le staphylocoque doré soit en augmentation. La gentamicine n’est efficace que sur 64,1% des micro-organismes. La résistance à cet antibiotique utilisé communément en prophylaxie va croissant. L’acide fusidique et l‘érythromycine donnent une meilleure couverture en prévention. Nous suggérons que sur la base de ces analyses microbiologiques, ces antibiotiques soient ajoutés de façon traditionnelle au ciment acrylique. Ceci donnera un meilleur résultat des antibiotiques sur le plan local lorsque l’on pratique une révision d’une prothèse articulaire pour infection.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Pi chart depicting microbiology of the infected total hip replacement. 1974–2005
Fig. 2
Fig. 2
Changing bacteriology in the infected total hip replacement 1974–2005
Fig. 3
Fig. 3
Sensitivity of all organisms at THR to antibiotics
Fig. 4
Fig. 4
Relative sensitivity of antibiotics to coagulase negative staphylococcus (CNS) and Staphylococcus aureus (SA)
Fig. 5
Fig. 5
Changing sensitivity patterns to CNS over time. 1974–2005
Fig. 6
Fig. 6
Changing sensitivity patterns to SA over time. 1974–2005
See this image and copyright information in PMC

References

    1. Lidwell OM, Lowbury EJ, Whyte W, Blowers R, Stanley SJ, Lowe D. Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study. Br Med J. 1982;285:10–14. doi: 10.1136/bmj.285.6334.10. - DOI - PMC - PubMed
    1. Hip replacement (2000) Getting it right the first time. The Controller and Auditor General, p 51
    1. Gristina AG, Costerton JW. Bacterial adherence to biomaterials and tissue. The significance of its role in clinical sepsis. J Bone Joint Surg. 1985;67-A:264–273. - PubMed
    1. Kevin L, Garvin MD, Steven H, Hinrichs MD, Joshua A, Urban MD. Emerging antibiotic-resistant bacteria: their treatment in total joint arthroplasty. Clin Orthop Relat Res. 1999;369:110–123. - PubMed
    1. Davis N, Curry A, Gambhir AK, Panigrahi H, Walker CRC, Wilkins EGL, Worsley M, Kay PR. Intraoperative bacterial contamination in operations for joint replacement. J Bone Joint Surg. 1999;81-B(5):886–890. doi: 10.1302/0301-620X.81B5.9545. - DOI - PubMed

MeSH terms