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J Knee Surg 2014; 27(05): 399-406
DOI: 10.1055/s-0033-1364102
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Organism Profile in Periprosthetic Joint Infection: Pathogens Differ at Two Arthroplasty Infection Referral Centers in Europe and in the United States

Vinay K. Aggarwal
1   Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, Pennsylvania
,
Hooman Bakhshi
1   Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, Pennsylvania
,
Niklas Unter Ecker
2   Department of Orthopaedic Surgery, HELIOS ENDO-Klinik Hamburg, Hamburg, Germany
,
Javad Parvizi
1   Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, Pennsylvania
,
Thorsten Gehrke
2   Department of Orthopaedic Surgery, HELIOS ENDO-Klinik Hamburg, Hamburg, Germany
,
Daniel Kendoff
2   Department of Orthopaedic Surgery, HELIOS ENDO-Klinik Hamburg, Hamburg, Germany
› Author Affiliations
Further Information

Publication History

07 November 2013

19 November 2013

Publication Date:
10 January 2014 (online)

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Abstract

Infecting microorganism is a strong predictor of treatment success for periprosthetic joint infection (PJI). The purpose of this study was to compare the infecting pathogens causing PJI at two large infection referral centers in the United States and in Europe. In this study, 898 consecutive cases of PJI were identified at the HELIOS ENDO-Klinik Hamburg in Europe and 772 cases were identified at the Rothman Institute in the United States. The incidence of organisms at the HELIOS ENDO-Klinik Hamburg versus the Rothman Institute was: coagulase-negative Staphylococcus (39.3 vs. 20.2%), S. aureus (13.0 vs. 31.0%), Streptococcus (6.5 vs. 5.8%), Enterococcus (7.0 vs. 3.9%), anaerobic (9.0 vs. 0.9%), fungal (0.3 vs. 2.3%), mycobacterial (0 vs. 0.6%), polymicrobial (3.4 vs. 7.4%), culture negative (16.1 vs. 15.8%), and other organisms (0.9 vs. 5.4%). The percentage of methicillin-resistant S. aureus was significantly higher at the American center than at the European center (48.1 vs. 12.8%; p < 0.0001). Our findings show higher virulence and resistance organisms are more prevalent at a referral center in the United States compared with one in Europe.

Keywords

periprosthetic joint infection - PJI - arthroplasty - Europe - United States
 

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