The incidence rate, trend and microbiological aetiology of prosthetic joint infection after total knee arthroplasty: A 13 years’ experience from a tertiary medical center in Taiwan

• Published in: Journal of microbiology, immunology and infection Vol. 51; no. 6; pp. 717 - 722
• Main Authors: Wang, Fu-Der, Wang, Yu-Ping, Chen, Cheng-Fong, Chen, Hsin-Pai
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.12.2018; Elsevier
• Subjects: Aged; Arthroplasty, Replacement, Knee - adverse effects; Bacteria - isolation & purification; Candida - isolation & purification; Female; Humans; Incidence; Knee Prosthesis - adverse effects; Male; Microbiological aetiology; Prosthesis-Related Infections - epidemiology; Prosthesis-Related Infections - microbiology; Prosthetic joint infection; Quality of Life; Retrospective Studies; Taiwan - epidemiology; Tertiary Care Centers; Total knee arthroplasty; Taiwan; Microbiological aetiology; Prosthetic joint infection; Total knee arthroplasty
• ISSN: 1684-1182; 1995-9133
• DOI: 10.1016/j.jmii.2018.08.011

Total knee arthroplasty (TKA) improves the patient's quality of life by relieving pain, correcting the deformity, and helping the patient resume normal activities. However, post-TKA prosthetic joint infection leads to implant failure, is difficult to treat, and causes a significant burden both economically and health-wise. Therefore, an understanding of the current trends in this infection and microbiology data is essential for preventing and treating it. A retrospective study was conducted on 10,768 patients who underwent primary TKA at Taipei Veterans General Hospital, Taiwan, from 2002 to 2014. The incidence of post-TKA prosthetic joint infection in different time periods was investigated, and microbiological results in early- (<3 months post-TKA) and delay-onset prosthetic joint infection were analyzed. The 2 years incidence of post-TKA prosthetic joint infection was 1.93% (2002–2006), 1.05% (2007–2010), and 0.76% (2011–2014). The incidence of post-TKA prosthetic joint infection decreased significantly from 2002 to 2014. Although Staphylococcus species was most commonly isolated, a significantly higher proportion of gram-negative bacteria were isolated from early-onset compared with delay-onset post-TKA prosthetic joint infection patients: 9/29 (31.0%) versus 13/100 (13%); p = 0.023. The results showed that the risk of post-TKA prosthetic joint infection is decreasing. Microbiology results showed that early-onset post-TKA prosthetic joint infection is associated with a higher risk of gram-negative bacterial infection. Physicians should be aware of this risk in order to correctly select empirical agents.