Pathogenic organisms in hip joint infections

Abstract

Infections of the hip joint are usually of bacterial etiology. Only rarely, an infectious arthritis is caused in this localization by viruses or fungi. Native joint infections of the hip are less common than infections after implantation of prosthetic devices. Difficulties in prosthetic joint infections are, (I) a higher age of patients, and, thus an associated presence of other medical risk factors, (II) often long courses of treatment regimes depending on the bacterium and its antibiotic resistance, (III) an increased mortality, and (IV) a high economic burden for removal and reimplantation of an infected prosthetic device. The pathogenic mechanisms responsible for articular infections are well studied only for some bacteria, e.g. Staphylococcus aureus, while others are only partially understood. Important known bacterial properties and microbiological characteristics of infection are the bacterial adhesion on the native joint or prosthetic material, the bacterial biofilm formation, the development of small colony variants (SCV) as sessile bacterial types and the increasing resistance to antibiotics.

Keywords: arthritis; bacteria; diagnosis; prosthesis; therapy.

Figure 1

(left) Raster electron microscopy of Staphylococcus aureus from broth culture; (right) Staphylococcus aureus biofilm. Images from S. Sailer und I. Chatterjee, Homburg/Saar.

Figure 2

Staphylococcus aureus as normal phenotype and as small colony variant (SCV). Note the different size and hemolysis (identical molecular pattern).