title: Clinical Characteristics of Methicillin-resistant Staphylococcus aureus Infection for Chronic Periprosthetic Hip and Knee Infection.
abstract: OBJECTIVE
  Deep infection after hip and knee arthroplasty is a serious complication and is difficult to treat due to its toxicity. The aims of our study were to find out the differences of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) infection after hip and knee arthroplasty focusing on clinical course and laboratory findings.
  
  
  METHODS
  We retrospectively reviewed 61 staphylococcal infection cases after hip and knee arthroplasty (MSSA in 25 patients, MRSA in 36 patients). Vital signs, laboratory tests, microbiology and clinical courses were analyzed. The average follow-up period was 3.8 years (range, 2 to 10.1 years).
  
  
  RESULTS
  At initial visit, MRSA group showed significant higher erythrocyte sedimentation rate, C-reactive protein (CRP) and neutrophil percentage. The average duration for the normalization of CRP was longer in MRSA group (MRSA: 36.7±25.1 days, MSSA: 24.7±13.6 days; P=0.008). The mean interval between staging operation was longer in MRSA group (MRSA: mean 8.7 weeks [range, 6.4 to 21.4 weeks], MSSA: mean 6.8 weeks [range, 6 to 13.1 weeks]; P=0.012). MRSA group (13.9%) revealed higher recurrence rate than MSSA group (4%). Two patients (5.6%) from MRSA group expired by sepsis. One limb amputation (2.7%) was carried out in MRSA group.
  
  
  CONCLUSIONS
  MRSA infection after arthroplasty showed more toxic serologic parameter and poorer prognosis. Aggressive treatment should be considered for MRSA infection following arthroplasty.
authors.affiliation: Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Ryu
authors.affiliation: Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
authors.forename: Joon Soon
authors.initials: JS
authors.lastname: Kang
authors.affiliation: Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
authors.forename: Kyoung Ho
authors.initials: KH
authors.lastname: Moon
authors.affiliation: Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
authors.forename: Myung Ku
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
authors.forename: Dae Gyu
authors.initials: DG
authors.lastname: Kwon
keywords: Antibiotic resistance; Arthroplasty; Infection; Methicillin-resistant Staphylococcus aureus; Vancomycin