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. 2016 Jun 4:1:25-30.
doi: 10.7150/jbji.15722. eCollection 2016.

Pseudomonas Prosthetic Joint Infections: A Review of 102 Episodes

Neel B Shah  1 , Douglas R Osmon  1 , James M Steckelberg  1 , Rafael J Sierra  2 , Randall C Walker  1 , Aaron J Tande  1 , Elie F Berbari  1
Affiliations

Pseudomonas Prosthetic Joint Infections: A Review of 102 Episodes

Neel B Shah et al. J Bone Jt Infect. .

Abstract

Background: The outcome of patients with Pseudomonas prosthetic joint infection (PS PJI) has not been well studied. The aim of this retrospective cohort study was to assess the outcome of patients with Pseudomonas PJI and to review risk factors associated with failure of therapy. Methods: Between 1/1969 and 12/2012, 102 episodes of PS PJI in 91 patients were identified. Results: The mean age at the time of diagnosis was 67.4 years; forty three percent had knee involvement. Over 40 percent had either diabetes mellitus or a history of gastrointestinal or genitourinary surgery. Nearly half (48 out of 102 episodes) received aminoglycoside monotherapy, while 25% received an anti-pseudomonal cephalosporin. The 2-year cumulative survival free from failure was 69% (95% CI, 56%-82%). Patients treated with resection arthroplasty, two-stage exchange, and debridement with implant retention had a 2-year cumulative survival free from failure of 80% (95% CI, 66%-95%), 83% (95% CI, 60%-100%), and 26% (95% CI, 23%-29%) respectively (P=0.0001). Conclusions: PS PJI's are associated with a high failure rate. Patients treated with debridement and implant retention had a worse outcome.

Keywords: Pseudomonas; arthroplasty; debridement and implant retention.; prosthetic joint infection.

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Conflict of interest statement

Competing Interests: No conflicts of interest are present between this work and any of the authors. This work was supported by Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Figures

Figure 1
Figure 1
Kaplan-Meier time dependent analysis assessing the outcome of 102 Pseudomonas PJI episodes seen at the Mayo Clinic between 1969 and 2012.
Figure 2
Figure 2
Kaplan-Meier time dependent analysis of Pseudomonas PJI, by type of surgical therapy. Patients with debridement and implant retention of their prosthesis had a significantly worse outcome when compared to resection arthroplasty and 2-stage exchange.
Figure 3
Figure 3
Kaplan-Meier time dependent analysis of Pseudomonas PJI, based on time period. Patients treated between 1969-1989 had a better outcome than those treated between 1990-2012 time period.
See this image and copyright information in PMC

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