J Bone Jt Infect 2016; 1:25-30. doi:10.7150/jbji.15722
Pseudomonas Prosthetic Joint Infections: A Review of 102 Episodes
1. Department of Internal Medicine and Division of Infectious Disease, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA.
2. Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA.
Shah NB, Osmon DR, Steckelberg JM, Sierra RJ, Walker RC, Tande AJ, Berbari EF. Pseudomonas Prosthetic Joint Infections: A Review of 102 Episodes. J Bone Jt Infect 2016; 1:25-30. doi:10.7150/jbji.15722. Available from http://www.jbji.net/v01p0025.htm
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: prosthetic joint infection, Pseudomonas, arthroplasty, debridement and implant retention.