title: Multiple Periprosthetic Joint Infections: Evidence for Decreasing Prevalence.
abstract: Multiple periprosthetic joint infections (MPJIs) are uncommon. We determine the prevalence of developing a second-site periprosthetic joint infection.
  
  
  
  Our institutional arthroplasty database was reviewed. Those who developed a second-site infection had a retrospective chart review to determine the pathogen, timing of infection, comorbidities, and results of treatment.
  
  
  
  Thirteen of 206 (6.3%) patients at-risk for MPJI experienced a second periprosthetic joint infection. Mode of the second infection was hematogenous in 6, all of whom were being treated for the index periprosthetic joint infection. Seven secondary infections did not relate to the index infection. Two patients were lost to follow-up, 5 continued on suppressive antibiotics, and 6 successfully cleared infection.
  
  
  
  The prevalence of MPJI has decreased compared with previous reports.
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Centre, University Hospital, Western University, London, Ontario, Canada.
authors.forename: John P
authors.initials: JP
authors.lastname: Haverstock
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Centre, University Hospital, Western University, London, Ontario, Canada.
authors.forename: Lyndsa E
authors.initials: LE
authors.lastname: Somerville
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Centre, University Hospital, Western University, London, Ontario, Canada.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Naudie
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Centre, University Hospital, Western University, London, Ontario, Canada.
authors.forename: James L
authors.initials: JL
authors.lastname: Howard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: complication; hematogenous spread; multiple infections; periprosthetic infection; revision