title: Outcome of group B streptococcal prosthetic hip infections compared to that of other bacterial infections.
abstract: 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.
authors.affiliation: Service de Chirurgie Osseuse et Traumatologique, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 75020 Paris, France. vzeller@hopital-dcss.org
authors.forename: Valérie
authors.initials: V
authors.lastname: Zeller
authors.forename: Marina
authors.initials: M
authors.lastname: Lavigne
authors.forename: David
authors.initials: D
authors.lastname: Biau
authors.forename: Philippe
authors.initials: P
authors.lastname: Leclerc
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Ziza
authors.forename: Patrick
authors.initials: P
authors.lastname: Mamoudy
authors.forename: Nicole
authors.initials: N
authors.lastname: Desplaces
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents