Trends in microbiological profiles and antibiotic resistance in periprosthetic joint infections

• Published in: Journal of international medical research Vol. 49; no. 3; p. 3000605211002784
• Main Authors: Hu, Lifeng, Fu, Jun, Zhou, Yonggang, Chai, Wei, Zhang, Guoqiang, Hao, Libo, Chen, Jiying
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics; China - epidemiology; Drug resistance; Drug Resistance, Microbial; Humans; Microbial Sensitivity Tests; Microorganisms; Pathogens; Prosthesis-Related Infections - drug therapy; Retrospective Clinical Research Report; Retrospective Studies; Staphylococcal Infections - drug therapy; Staphylococcus aureus; Trends; China; knee; antibiotic resistance; microbiology; periprosthetic joint infection; Joint replacement; hip; Staphylococcus
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/03000605211002784

Objective This study examined the trends in demographics, the distribution of microorganisms, and antibiotic resistance in patients with periprosthetic joint infection (PJI). Methods We conducted a retrospective study of 231 consecutive patients diagnosed with PJI in our hospital from January 2006 to December 2015 (93 and 138 patients diagnosed in 2006–2010 and 2011–2015, respectively). The linear-by-linear chi-squared test was used to assess the trends in demographics, the distribution of microorganisms, and antibiotic resistance. Results Gram-positive cocci accounted for 63.9% of all pathogens, and coagulase-negative Staphylococcus (CoNS) accounted for 38.1% of all isolates. The proportion of isolates identified as methicillin-resistant CoNS significantly increased over the study period (39.0% vs. 61.8%). In addition, the proportions of levofloxacin-resistant CoNS (4.9% vs. 21.8%) and Staphylococcus aureus (6.3% vs. 45.0%) isolates significantly increased over the study period. By contrast, the proportions of penicillin-resistant CoNS (82.9% vs. 40.0%) and S. aureus (75.0% vs. 30.0%) isolates decreased over the study period. Conclusion Our research revealed changes in the distribution of microorganisms and antibiotic resistance profile of the pathogens responsible for PJI over time, which could complicate treatment. These findings may serve as a reference for strategies to prevent and empirically treat PJI in China.