The microbiology of infected hip arthroplasty.
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.
Rafiq
Imran
I
Centre for Hip Surgery, Wrightington Hospital, Wigan, England, UK. imranrafiq@doctors.org.uk
Gambhir
A K
AK
Wroblewski
B M
BM
Kay
P R
PR
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
D003030:Coagulase