title: Outcome of penicillin-susceptible streptococcal prosthetic joint infection treated with debridement and retention of the prosthesis.
abstract: Debridement with retention of the prosthesis was the initial treatment modality for 19 cases of penicillin-susceptible streptococcal prosthetic joint infection that occurred in 18 patients who presented to the Mayo Clinic (Rochester, Minnesota) during 1969-1998. All of the cases of prosthetic joint infection occurred >30 days after implantation of the prosthesis, which was well fixed at the time of debridement. The median duration of symptoms before debridement was 4 days (range, 1-10 days). Treatment failure (defined as relapse of infection with the original microorganism) occurred in 2 cases (10.5%) during a median follow-up period of 3.9 years (range, 0.3-21.7 years). The 1-year cumulative risk of relapse was 11% (95% confidence interval, 0%-26%). Relapse of prosthetic joint infection due to penicillin-susceptible streptococci after debridement and retention of the prosthesis is uncommon. For patients who present with a well-fixed prosthesis and a short duration of symptoms, debridement with retention appears to be an effective treatment modality.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Meehan
authors.forename: D R
authors.initials: DR
authors.lastname: Osmon
authors.forename: M C T
authors.initials: MC
authors.lastname: Duffy
authors.forename: A D
authors.initials: AD
authors.lastname: Hanssen
authors.forename: M R
authors.initials: MR
authors.lastname: Keating
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003646:Debridement; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000494:pharmacology / Q000627:therapeutic use; D019736:Prostheses and Implants; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D013291:Streptococcus / Q000187:drug effects; D017211:Treatment Failure
chemical_list: D010406:Penicillins