title: [Arthroplasty-related infection: incidence, risk factors, clinical features, and outcome].
abstract: BACKGROUND
  There is little information about the overall incidence, risk factors, and clinical management of arthroplasty-related infection in Spain.
  
  
  METHODS
  The incidence of surgical site infection (SSI) in hip and knee arthroplasty from 2001 to 2005 was determined. Risk factors for SSI were investigated in 435 patients using multivariate logistic regression analysis. Clinical features and treatment were examined in a cohort of 58 consecutive patients with joint arthroplasty infection.
  
  
  RESULTS
  The percentages of SSI in hip and knee arthroplasty stratified according to the National Nosocomial Infection Surveillance (NNIS) index were 1.86% and 1.62% (NNIS=0), 3.72% and 2.02% (NNIS=1), and 7.20% and 6.71% (NNIS=2-3), respectively. The risk factors identified for developing SSI included secondary arthroplasty, duration of urinary catheterization, and hip arthroplasty. Fifty percent of patients with arthroplasty infection had type I (early) or III (hematogenous) infection. Gram-positive cocci were the most frequent causes. Initial therapy consisted in debridement with preservation of the prosthesis (10 patients) or removal of the prosthesis (40 patients); surgery was not performed in 8 patients. After one year of follow up, 39 patients (67%) were considered cured, 12 (21%) had a recurrence or were under chronic suppressive antimicrobial therapy, and 7 (12%) had died.
  
  
  CONCLUSIONS
  The incidence of SSI in our center is similar to that of other Spanish hospitals, but is higher than the notified incidence in the NNIS system. A modifiable risk factor (urinary catheterization) has been identified. Greater consensus for the management of these patients is desirable.
authors.affiliation: Sección de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Sevilla, Spain. jrb@nacom.es
authors.forename: Jesús
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.forename: María Dolores
authors.initials: MD
authors.lastname: del Toro
authors.forename: Carmen
authors.initials: C
authors.lastname: Lupión
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Suárez
authors.forename: Luis
authors.initials: L
authors.lastname: Silva
authors.forename: Isabel
authors.initials: I
authors.lastname: Nieto
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Muniain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology; D003646:Debridement; D020878:Device Removal / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D014546:Urinary Catheterization / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents