Etiology of implant orthopedic infections: A survey on 1027 clinical isolates

Carla Renata Arciola, Y. H. An, D. Campoccia, M. E. Donati, L. Montanaro

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

In spite of the recent achievements derived from modern protocols of prophylaxis, orthopedic surgical infections still remain unacceptably frequent, especially in light of the often devastating outcomes of septic complications. The spectrum and the prevalence of the bacteria most frequently involved in orthopedic infections are here explored, with particular reference to those infections associated to implant biomaterials, which were grouped based on device typology. During a 30 months period (from September 2000 to April 2003), 1027 microbial strains were consecutively isolated from 699 patients undergoing revision surgery at the Rizzoli Orthopedic Institute. 775 (75.5%) of all these microorganisms were identified as belonging to the Staphylococcus genus, 82 (8%) to the Enterobacteriaceae family, 75 (7.3%) to the Pseudomonas genus, 54 (5.3%) to the Enterococcus genus and 20 (1.9%) to the Streptococcus genus. While confirming the importance of staphylococci as the most diffuse cause of infection, our data indicate an unexpectedly high prevalence of S. epidermidis on infected hip and knee arthroprostheses, respectively of 42% and 44%. The spectrum of bacteria infecting either internal or external fracture fixation devices appears to differ from that of hip and knee arthroprostheses and more closely resembles that of infections non-associated to medical devices, being characterized by a relatively higher prevalence of Staphylococcus aureus (over 40%) and Pseudomonas aeruginosa. Enterobacteriaceae and members of the Streptococcus and Corynebacterium genera are frequently associated with implants in which surgical incisions were made near the perineum, determining a completely altered spectrum.

Original languageEnglish
Pages (from-to)1091-1100
Number of pages10
JournalInternational Journal of Artificial Organs
Volume28
Issue number11
Publication statusPublished - Nov 2005

Fingerprint

Orthopedics
Bacteria
Fracture fixation
Infection
Enterobacteriaceae
Streptococcus
Staphylococcus
Biocompatible Materials
Hip
Knee
Biomaterials
Microorganisms
Surgery
Perineum
External Fixators
Equipment and Supplies
Corynebacterium
Fracture Fixation
Enterococcus
Pseudomonas

Keywords

  • Biomaterials
  • Implant infections
  • Medical devices
  • Opportunistic bacteria
  • Orthopedic prostheses

ASJC Scopus subject areas

  • Biophysics

Cite this

Etiology of implant orthopedic infections : A survey on 1027 clinical isolates. / Arciola, Carla Renata; An, Y. H.; Campoccia, D.; Donati, M. E.; Montanaro, L.

In: International Journal of Artificial Organs, Vol. 28, No. 11, 11.2005, p. 1091-1100.

Research output: Contribution to journalArticle

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