Τίτλος:
A comparative study of heterogeneous antibiotic resistance of microbial populations in conventional periprosthetic tissue cultures and sonication fluid cultures of orthopaedics explanted prostheses
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: “Heterogeneity” describes a phenomenon where subpopulations of seemingly isogenic bacteria exhibit a range of susceptibilities to a particular antibiotic. We aim to investigate the frequency of heterogeneity among microbes isolated from infected prostheses, and its possible correlation with microbial resistance. Methods: Between May 2014 and June 2019, we investigated 234 patients, at our institution, undergoing revision arthroplasty because of loosening of the prostheses or because of periprosthetic joint infection. All patients had periprosthetic tissue culture, sonication of prosthesis and direct inoculation of Sonication fluid into blood culture bottles. We assessed the presence of heterogeneity among all pathogens isolated from infected prostheses. Results: Using standard non-microbiological criteria to determine periprosthetic joint infection, it was found that 143 patient (61.1%) had aseptic loosening while 91 patients (38.9%) had periprosthetic joint infection. Comparing the two methods, the results of our study showed that the method of sonication was significantly more sensitive than tissue culture [91% (83–96) vs. 43% (33–54); p ' 0.005]. In this study, heterogeneity was reported in 15 cases, 16.5% of all infections and 6.4% in the total population. In our study, Staphylococcusepidermidis was the most commonly isolated strain followed by Staphylococcus aureus, at a rate of 35.2% and 19.8%, respectively. Antibiotics in which the microorganisms exhibited heterogeneous bacterial behavior most frequently were Gendamicin (5.3%), Vancomycin (4.9%). Conclusion: There is increasing evidence that heterogeneity can lead to therapeutic failure and that the detection of this phenotype is a prerequisite for a proper antibiotic choice to have a successful therapeutic effect. © 2020, Springer-Verlag France SAS, part of Springer Nature.
Συγγραφείς:
Banousi, A.
Evangelopoulos, D.S.
Stylianakis, A.
Fandridis, E.
Chatziioannou, S.
Sipsas, N.V.
Pneumaticos, S.G.
Περιοδικό:
EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY
Εκδότης:
Springer-Verlag Italia s.r.l.
Λέξεις-κλειδιά:
ciprofloxacin; clindamycin; erythromycin; gentamicin; linezolid; moxifloxacin; oxacillin; teicoplanin; tigecycline; trimethoprim; vancomycin, adult; aged; antibiotic resistance; antibiotic sensitivity; Article; bacterium detection; bacterium isolation; controlled study; correlational study; diagnostic accuracy; diagnostic test accuracy study; dispersity; drug effect; female; human; intermethod comparison; major clinical study; male; microbial population; microbiological examination; microbiological parameters; periprosthetic joint infection; periprosthetic tissue culture; priority journal; prospective study; prosthesis loosening; quality of life; revision arthroplasty; sensitivity and specificity; sonication fluid culture; Staphylococcus aureus; Staphylococcus epidermidis; Staphylococcus haemolyticus; tissue culture; treatment failure; antibiotic resistance; infection; orthopedics; prostheses and orthoses; ultrasound, Drug Resistance, Microbial; Humans; Orthopedics; Prostheses and Implants; Prosthesis-Related Infections; Sonication
DOI:
10.1007/s00590-020-02704-4
