Clostridial prosthetic joint infections: A series of 16 cases and literature review

Abstract

Objectives: Prosthetic joint infections (PJIs) due to the Clostridium species have not been widely investigated. We aimed to characterize these uncommon infections.

Methods: We conducted a retrospective study between 2003 and 2020 in six French hospitals combined with a review of the literature.

Results: The main conclusions obtained from the 16 patients included were reinforced by the literature analysis: (i) Clostridium perfringens was the most frequently involved species, (ii) patients presented an advanced age at the time of prosthesis placement and infection, (iii) most of the infections were early- or delayed-onset, (iv) the prognosis for these PJIs remains poor, (v) when performed (n = 5), DAIR with 12-week antimicrobial therapy led to a favorable outcome in 80% of cases.

Conclusions: Given the low incidence of this infection, our work represents the largest series of clostridial PJIs reported to date and highlights some specificities of these infections. Further prospective studies are needed to confirm these results.

Keywords: Case series; Clostridium perfringens; Literature review; Prosthetic joint infections.