title: A four-year prospective study on microbial ecology of explanted prosthetic hips in 52 patients with "aseptic" prosthetic joint loosening.
abstract: The bacteriology of explanted prosthetic hips and surrounding soft tissue was studied in 52 patients undergoing surgical revision for joint loosening. In a prospective four-year study, positive bacterial cultures were recorded in 34 (76%) patients. Coagulase-negative staphylococci were the predominant isolates, and 11 patients (33%) had more than three organisms isolated, 7 (20%) had two only, and 11 (33%) had one species. Among the 23 patients from whom specimens from all 11 predetermined anatomic sites were cultured, the highest frequency of positive cultures (52% and 47%) came from the shaft and capsular tissue, respectively. Organisms were less frequently recovered from the cement and acetabulum (13% and 4%, respectively). Using molecular typing in eight patients with paired isolates of the same species, clonal identity was found in four. An additional patient underwent a second revision for loosening 17 months after the first revision and the same clone of Staphylococcus epidermidis was isolated on both occasions.
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Cologne, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Perdreau-Remington
authors.forename: D
authors.initials: D
authors.lastname: Stefanik
authors.forename: G
authors.initials: G
authors.lastname: Peters
authors.forename: C
authors.initials: C
authors.lastname: Ludwig
authors.forename: J
authors.initials: J
authors.lastname: Rütt
authors.forename: R
authors.initials: R
authors.lastname: Wenzel
authors.forename: G
authors.initials: G
authors.lastname: Pulverer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015169:Colony Count, Microbial; D003352:Corynebacterium / Q000254:growth & development / Q000302:isolation & purification; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000254:growth & development / Q000302:isolation & purification; D005260:Female; D006094:Gram-Positive Bacteria / Q000254:growth & development / Q000302:isolation & purification*; D006622:Hip Prosthesis / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D012086:Reoperation; D013210:Staphylococcus / Q000254:growth & development / Q000302:isolation & purification