title: [Periprosthetic infections following total hip replacement with ESBL-forming bacteria: importance for clinical practice].
abstract: Implant infections remain feared and severe complications after total hip replacement. An even higher rate of periprosthetic infections can be observed after revision surgery in comparison to primary total hip replacement. An additional threat for patients with artificial joints arises from the fact that bacteria resistant to a multitude of antibiotics are encountered with increasing frequency in the hospital setting.Among these the enterobacteria producing extended spectrum β-lactamases (ESBL) are the second most frequent group of multiresistant pathogens. ESBLs are enzymes which possess the ability to hydrolyse third and fourth generation cephalosporins resulting in a distinctive resistance against these antibiotics. Even though ESBLs were first described in the early 1980's and now represent pathogens of utmost importance in intensive care units, they have been hardly considered in orthopedic and trauma surgery.In the present manuscript we provide an overview of the epidemiology and diagnostics of ESBL-expressing bacteria and demonstrate the difficulties in managing implant-associated infections with resistant bacteria. Furthermore, we emphasize the importance of recognizing ESBL-positive bacteria as increasingly important pathogens which require special precautions and treatment. Clinical evaluations suggest that ESBLs in orthopedic and trauma surgery are not a rare phenomenon any more.
authors.affiliation: Orthopädische Klinik und Poliklinik, Universität Rostock, Doberaner Str. 142, 18057 Rostock, Deutschland. maximilian.haenle@med.uni-rostock.de
authors.forename: M
authors.initials: M
authors.lastname: Haenle
authors.forename: A
authors.initials: A
authors.lastname: Podbielski
authors.forename: M
authors.initials: M
authors.lastname: Ellenrieder
authors.forename: R
authors.initials: R
authors.lastname: Skripitz
authors.forename: K
authors.initials: K
authors.lastname: Arndt
authors.forename: W
authors.initials: W
authors.lastname: Mittelmeier
authors.forename: R
authors.initials: R
authors.lastname: Bader
authors.forename: H
authors.initials: H
authors.lastname: Gollwitzer
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D004756:Enterobacteriaceae Infections / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D001618:beta-Lactamases