title: The microbiology of infected hip arthroplasty.
abstract: Infection following joint replacement surgery although rare presents a challenging problem. Bacterial resistance to antibiotics is an emerging problem. We analysed the microbiology of 337 single-stage revisions for deep infection. Coagulase negative staphylococcus was found to be the predominant organism, although staphylococcus aureus is gaining importance. Gentamicin only provides cover for 64.1% of organisms. Resistance to this commonly used antibiotic prophylaxis is escalating. Fusidic acid and erythromycin provide improved cover. We would suggest on a microbiological basis that these antibiotics be considered for addition to acrylic bone cement. This will provide local antibiotic delivery when performing a revision for deep infection.
authors.affiliation: Centre for Hip Surgery, Wrightington Hospital, Wigan, England, UK. imranrafiq@doctors.org.uk
authors.forename: Imran
authors.initials: I
authors.lastname: Rafiq
authors.forename: A K
authors.initials: AK
authors.lastname: Gambhir
authors.forename: B M
authors.initials: BM
authors.lastname: Wroblewski
authors.forename: P R
authors.initials: PR
authors.lastname: Kay
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D003030:Coagulase / Q000145:classification; D003428:Cross Infection / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy; D006801:Humans; D008826:Microbial Sensitivity Tests; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000145:classification / Q000188:drug therapy*; D013290:Streptococcal Infections / Q000188:drug therapy
chemical_list: D003030:Coagulase