Deep infection of cemented total hip arthroplasties caused by coagulase-negative staphylococci.
We reviewed a series of 91 patients with deep infection of a cemented total hip arthroplasty caused by coagulase-negative staphylococci (C-NS). Of these, 72 were treated by one-stage exchange arthroplasty with a failure rate of 13% due to recurrence of infection. The other 19 patients have started or completed treatment by a two-stage exchange without failure to date. In 27 of the 91 patients multiple strains of C-NS were discovered, many being resistant to previously used antibiotics. The use of gentamicin-containing cement in the primary arthroplasty was significantly associated with the emergence of gentamicin-resistant C-NS in subsequent deep infection. Bacteriological diagnosis of such infections must take into consideration the possibility that multiple strains of the organism are involved.
Hope
P G
PG
Northern General Hospital, Sheffield, England.
Kristinsson
K G
KG
Norman
P
P
Elson
R A
RA
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001843:Bone Cements / Q000627:therapeutic use*; D003030:Coagulase / Q000032:analysis; D004343:Drug Implants; D004352:Drug Resistance, Microbial; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000379:methods; D006801:Humans; D008826:Microbial Sensitivity Tests; D011475:Prosthesis Failure; D012008:Recurrence; D012086:Reoperation; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D013210:Staphylococcus / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D003030:Coagulase; D004343:Drug Implants