Outcome of group B streptococcal prosthetic hip infections compared to that of other bacterial infections.
BACKGROUND
Outcome of streptococcal prosthetic hip infection is often thought to be better than that caused by other pathogens. That supposition was not confirmed in our experience with group B streptococcal prosthetic joint infection.


OBJECTIVE
We compared outcomes of group B streptococcal and other-pathogen prosthetic hip infections.


METHODS
One hundred and thirty nine patients, 24 with group B streptococcal and 115 other-pathogen prosthetic hip infections, were included. The primary outcome was the time from surgical treatment to treatment failure, defined as relapse, infection- or treatment-related death. Secondary outcomes were the times from surgical treatment to relapse or any event (event-free survival). The cumulative incidence estimator was used to model primary and secondary outcomes. Multivariable regression analysis was used to determine a set of independent predictors of treatment failure.


RESULTS
With a median follow-up of 22 months, treatment failed more frequently in patients with group B streptococcal prosthetic hip infections (hazard ratio, 4.88 [95% CI, 1.4-17], P=.012). Multivariable analysis retained the American Society of Anesthesiologist score and group B streptococcal infection as independent risk factors of treatment failure; event-free survival was lower for these patients (hazard ratio, 2.64 [95% CI, 1.2-6], P=.02).


CONCLUSIONS
Despite high antibiotic susceptibility, outcomes of group B streptococcal and other-pathogen prosthetic hip infection differ.
Zeller
Valérie
V
Service de Chirurgie Osseuse et Traumatologique, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 75020 Paris, France. vzeller@hopital-dcss.org
Lavigne
Marina
M
Biau
David
D
Leclerc
Philippe
P
Ziza
Jean Marc
JM
Mamoudy
Patrick
P
Desplaces
Nicole
N
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D016016:Proportional Hazards Models; D011475:Prosthesis Failure; D012044:Regression Analysis; D012086:Reoperation / Q000706:statistics & numerical data; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013292:Streptococcus agalactiae; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents