title: Prosthetic joint infections due to methicillin-resistant and methicillin-susceptible staphylococci treated with open debridement and retention of the prosthesis.
abstract: OBJECTIVE
  To compare the specific characteristics, the outcome and the predictors of failure of prosthetic joint infections (PJI) due to methicillin-resistant (MRS) and methicillin- susceptible staphylococci (MSS) treated with open debridement and retention of the implant.
  
  
  METHODS
  PJI due to MRS or MRS prospectively registered in a database from 1999 to 2009 were retrospectively reviewed.
  
  
  RESULTS
  During the study period, 96 patients met the inclusion criteria of the study. The mean follow-up period was 3.9 years and at least 2 years in all patients. The failure rate was 25%. The only variable significantly associated with failure in the global cohort was polymicrobial infection (59.3% vs. 40.7%, p=0.036). Thirty-four (35.4%) patients had an infection due to MRS and 62 (63.6%) due to MSS. Among MSS infections, 95.2% corresponded to primary arthroplasties while 29.4% of PJI due to MRS were after revision arthroplasties (p=0.001). CRP was significantly higher in PJI due to MSS (5.2 mg/dl vs 9.1 mg/dL, p=0.02).The failure rate (20% vs 27%, p=0.62) was very similar in MSS and MRS groups.
  
  
  CONCLUSIONS
  PJI due to MRS were mainly coagulase-negative staphylococci, more frequent after revision arthroplasties, had a lower inflammatory response, and had a similar failure rate than MSS infections.
authors.affiliation: Eduard Tornero, Department of Orthopedic and Trauma Surgery, Hospital Clínic of Barcelona, C/ Villarroel 170, Barcelona 08036, Spain. etornero@clinic.ub.es.
authors.forename: Eduard
authors.initials: E
authors.lastname: Tornero
authors.forename: Laura
authors.initials: L
authors.lastname: Morata
authors.forename: Juan C
authors.initials: JC
authors.lastname: Martínez-Pastor
authors.forename: Guillem
authors.initials: G
authors.lastname: Bori
authors.forename: Josep
authors.initials: J
authors.lastname: Mensa
authors.forename: Alex
authors.initials: A
authors.lastname: Soriano
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D007596:Joints / Q000601:surgery; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects*; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents