Abstract
Together with Granulicatella spp., A. defectiva was formerly classified within the group of nutritionally variant streptococci (NVS). NVS-related endocarditis has been associated with higher rates of complications, bacteriological failure, and mortality compared to other streptococci, partially due to challenges related to timely and accurate identification. PJI caused by A. defectiva are rarely reported, and standardized management strategies have not yet been established. We describe a case of a 68-year-old man with concomitant A. defectiva PJI and native mitral valve endocarditis. The patient was managed conservatively for endocarditis and subsequently underwent a two-stage arthroplasty of the infected prosthetic knee. A. defectiva was identified using MALDI-TOF mass spectrometry on both synovial fluid and blood cultures. As penicillin susceptibility data were not available, the patient was treated with vancomycin at a dose of 2 g/day, resulting in a favorable clinical response. In addition, we performed a literature review on A. defectiva and Granulicatella PJI. Despite the limited number of reported cases in the literature, the findings suggest a potential correlation between clinical outcomes and antimicrobial treatment duration. Further comprehensive studies are needed to establish standardized management strategies for A. defectiva and Granulicatella PJI.
1. Introduction
Abiotrophia defectiva is commonly found as a commensal in the oral, urogenital, and intestinal microbiota. Despite its typically benign presence, it may express virulence factors that confer pathogenic potential. Although infections are infrequent, A. defectiva has been recognized as a possible causative agent of bacteremia and culture-negative endocarditis [1,2].
Formerly classified within the nutritionally variant streptococci (NVS) group, along with Granulicatella species, these bacteria are characterized as fastidious Gram-positive organisms that require enriched media to grow under standard culture conditions. Consequently, their isolation and subsequent antimicrobial susceptibility testing can pose significant challenges for clinical microbiology laboratories [3]. Proteomic analyses have further demonstrated that these organisms express several multifunctional “moonlighting proteins”, which contribute to enhanced bacterial colonization, the stimulation of inflammatory responses, the disruption of host cellular homeostasis, and the modulation of host immunity [1]. A. defectiva exhibits a marked ability to adhere to fibronectin, which accounts for its tropism for endothelial valvular tissue. Although the initial clinical presentation may be indolent, disease progression with deterioration is commonly observed, characterized by the formation of large vegetations and significant structural changes to the affected valves. These pathological changes can lead to severe embolic events and progressive heart failure [4].
Osteomyelitis and osteoarticular infections caused by A. defectiva have rarely been reported. Nevertheless, there is growing interest in the pathogenic potential of both Granulicatella and Abiotrophia species in implant-associated infections. The concomitant occurrence and management of endocarditis and prosthetic joint infection (PJI) has been reported for Granulicatella para-adiacens, with favorable outcomes achieved using the DAIR approach for PJI and conservative treatment for endocarditis [5], but not for A. defectiva.
Determining the most effective antimicrobial therapy for NVS infections remains challenging. The inherently slow replication rate of these organisms may reduce their susceptibility to penicillin and contribute to the development of penicillin tolerance. Among available agents, ceftriaxone demonstrates the highest efficacy; however, its activity against biofilm-associated bacteria remains limited. In their analysis of susceptibility profiles to newer antimicrobials, Cañas et al. reported the emergence of high-level resistance to daptomycin. Notably, daptomycin nonsusceptibility may be present at baseline or may develop during the course of therapy, whether administered as monotherapy or in combination [6].
We conducted a review of the existing literature on prosthetic joint infections caused by A. defectiva and Granulicatella species, supplemented by a clinical case of knee PJI with concurrent endocarditis due to A. defectiva.
2. Case Description
A 68-year-old male with a medical history of insulin-dependent type 2 diabetes mellitus and mitral valve Barlow syndrome underwent total left knee arthroplasty in October 2023 for painful osteoarthritis at an outside institution. Notably, he had experienced a self-limiting febrile episode prior to the prosthetic implantation. Approximately one month postoperatively, the patient developed another febrile illness, initially attributed to a urinary tract infection, with Enterococcus faecalis isolated from a urine culture. Despite receiving oral antimicrobial therapy and the resolution of urinary symptoms, the patient continued to experience intermittent fever and developed initial mild knee swelling without associated joint pain. An initial arthrocentesis revealed Gram-positive cocci in the synovial fluid, although subsequent cultures remained negative.
The patient was referred to our hospital in January 2024 for further evaluation. Repeat blood cultures and synovial fluid analysis were performed. The synovial fluid appeared turbid, with elevated glucose levels (164 mg/dL) and a leukocyte count of 16,500 cells/mm3 with 85% neutrophils. Both blood and synovial fluid cultures yielded the growth of A. defectiva, identified via MALDI-TOF mass spectrometry.
Transoesophageal echocardiography demonstrated multiple large vegetations on the mitral valve (6 × 3 mm, 13 × 7 mm, and 6 × 4 mm) with severe mitral regurgitation despite the absence of clinical signs of heart failure. Following cardiothoracic surgery consultation, a conservative management strategy was adopted, considering the patient’s hemodynamic stability and the associated risk–benefit profile. Due to unavailability of antimicrobial susceptibility testing, the patient was initiated on vancomycin (2 g/day), resulting in prompt defervescence and a decline in C-reactive protein levels. Despite clinical improvement, radiological imaging identified multiple asymptomatic embolic events in the spleen and brain.
The patient was referred to the original institution for a two-stage arthroplasty, which was performed 4 weeks after the initiation of antibiotic therapy. Antimicrobial treatment was continued for six weeks following prosthesis removal. The outpatient follow-up demonstrated normalization of inflammatory biomarkers, and the patient remains under regular cardiology and cardiothoracic follow-up to evaluate the potential need for mitral valve surgery. He underwent successful prosthetic joint reimplantation in November 2024 and, to date, remains free of infection relapse.
3. Literature Review Results
We conducted a literature search on Pubmed and Google Scholar by using the following research string: ((Abiotrophia) OR (Granulicatella)) AND (prosthetic joint infection). Table A1 and Table A2 in Appendix A present the characteristics of the clinical cases. A total of 21 case reports were found; we analyzed data from 22 patients (including our own case) to explore potential associations between clinical factors and outcome. Considering all cases, we aimed to identify variables associated with the dichotomous outcome classified as cured vs. non-cured PJI, defining “non-cured” as reported relapse, reinfection, or complicated clinical course. Although the small sample size precluded statistically robust conclusions, some interesting patterns have been highlighted (Table A3, Appendix A). A total of 11 cases involving A. defectiva and 10 cases of Granulicatella adiacens were analyzed, and we only analyze 1 case of Granulicatella para-adiacens. Overall, the outcomes were favorable in most patients treated for A. defectiva or Granulicatella-related PJI: one patient experienced a true relapse, one died due to pneumonia, and another developed a reinfection with Enterobacter cloacae, which complicated the clinical course. The mean age of the cured patients was 66.9 (SD = 7.87), approximately 5 years younger than the non-cured group. Interestingly, the surgical strategy appeared to be a potential factor influencing favorable outcomes: two out of the three non-cured patients were managed with a debridement, antibiotics, and implant retention (DAIR) approach, whereas the majority of cured patients (73.7%) underwent a two-stage exchange procedure. However, given that some cases were successfully treated with the DAIR approach, the association between surgical strategy and outcome may depend more on the appropriateness of patient selection and adherence to established indications for DAIR. Features related to treatment duration appeared to be of particular interest. Despite the limited number of cases, this variable reached statistical significance: the average duration of treatment in the non-cured group was 5.7 vs. 15.2 weeks in the cured group (p = 0.048). These findings suggest potential prognostic factors associated with PJI outcomes, which warrant confirmation in larger, dedicated studies.
4. Discussion
Formerly assigned to the NVS group, A. defectiva (along with Granulicatella spp.) is more commonly reported in the literature as a causative agent of bacteremia and endocarditis rather than prosthetic joint infections [7]. A. defectiva typically colonizes the skin and mucosal surfaces, with odontogenic procedures or other invasive or micro-invasive procedures often serving as a primary source of bacteremia. Oral colonization rates have been reported to reach approximately 12%, and NVS can also colonize the gastrointestinal and genitourinary tracts [8].
Their fastidious growth requirements often result in misidentification and underdiagnosis, thereby underestimating their pathogenic role and impacting decisions regarding de-escalation and antimicrobial stewardship. As noted by Téllez et al., A. defectiva and Granulicatella share similar clinical characteristics and outcomes, resembling other forms of subacute infective endocarditis in terms of mortality rates [9]. Nevertheless, several studies have reported higher complication rates, including embolism, valvular and peri-valvular damage, and antibiotic treatment failure, even when penicillin susceptibility is documented [10]. These complications are believed to be associated with the microorganisms’ ability to produce exopolysaccharide in vivo and their strong affinity for fibronectin binding. In addition, NVS species have significantly slower generation times compared to viridans streptococci, which may reduce the efficacy of beta-lactam antibiotics and contribute to the mechanisms of penicillin tolerance [11]. Standard antimicrobial susceptibility testing is often not feasible due to poor growth; in such cases, molecular diagnostic methods such as 16S rRNA sequencing are frequently necessary for microbial identification. Ratcliffe et al. [12] compared identification methods, demonstrating that Vitek 2 is less effective than MALDI-TOF mass spectrometry in detecting these fastidious organisms. Although 16S rRNA gene sequencing is considered the gold standard for identifying difficult-to-culture microorganisms, its use remains limited by high costs and prolonged turnaround times [12].
Prosthetic joint infections caused by A. defectiva are rarely reported in the literature, and no specific treatment guidelines exist for managing infections involving prosthetic hardware. In the context of infective endocarditis, the American Heart Association guidelines recommend treatment based on penicillin MIC for Granulicatella and A. defectiva infections, typically including gentamicin in combination with either ampicillin or penicillin, mirroring the approach used for enterococcal endocarditis; vancomycin alone is also considered a viable alternative [13]. Similarly, the 2023 European Society of Cardiology (ESC) Guidelines for Infective Endocarditis recommend a six-week regimen of penicillin G, ceftriaxone, or vancomycin, combined with aminoglycoside, for at least the first two weeks in the case of prosthetic valve endocarditis [14]. A study by Alberti et al. reported no vancomycin resistance and low aminoglycoside resistance among isolates of A. defectiva, Granulicatella adiacens, and Granulicatella elegans. Penicillin susceptibility was variable, with 53% of isolates showing intermediate susceptibility (MIC 0.25–2 µg/mL). Granulicatella species were generally more susceptible to penicillin than A. defectiva, while the latter showed greater susceptibility to ceftriaxone with variable rates of penicillin resistance [3]. The study of Cañas et al. confirms high susceptibility of A. defectiva strains to ceftriaxone. Moreover, all included strains were susceptible to vancomycin, although the bactericidal activity of this antibiotic might be limited by the detection of tolerance in vitro. Regarding newer antimicrobials, high levels of baseline resistance to daptomycin have been shown among Granulicatella and A. defectiva clinical isolates, limiting their use as monotherapy. Furthermore, resistance to daptomycin may develop rapidly even when susceptible at baseline and even when used in combination with ampicillin, gentamicin, or cephalosporins [6]. In the study of Prasidthrathsint et al. involving 599 NVS isolates (152 A. defectiva and 447 Granulicatella spp.), only 14% of A. defectiva isolates were penicillin-susceptible (21/152), although 97% of penicillin-resistant strains remained susceptible to ceftriaxone [15].
In our case, due to the unavailability of both A. defectiva antibiogram and the resistance genotype, vancomycin was empirically selected as the most reasonable treatment option. Considering the concomitant presence of prosthetic joint infection (PJI) and infective endocarditis, along with the absence of microbial growth for susceptibility testing, a more aggressive therapeutic strategy was adopted. This included broad-spectrum coverage targeting Gram-positive bacteria in consideration of potential β-lactam resistance or an undetected polymicrobial infection. Vancomycin was administered via continuous infusion, supported by therapeutic drug monitoring, which allowed for optimized pharmacokinetics, improved penetration into bone and valvular tissue, and reduced risk of toxicity. Additionally, a two-stage prosthetic arthroplasty was undertaken to reduce microbial burden and eradicate biofilm formation on the infected implant. Although the role of rifampin remains undefined in NVS non-endocardial pathology, in our review, its use has been reported in 5 out of 22 cases, which had a favorable outcome. However, concerns regarding polypharmacy and potential drug–drug interactions often limit its practicality in combination therapy, as in our clinical scenario. Similarly, prolonged combination therapy with an aminoglycoside was avoided due to the associated risk of nephrotoxicity.
Our case posed several challenges. Unlike most reported cases where a dental source was suspected, our patient had no history of recent odontogenic procedures, and the primary source of bacteremia remained unclear, though a prior urinary tract infection was documented. Secondly, in the absence of antimicrobial susceptibility data, treatment was guided by the most reasonable empiric option, balancing literature-based susceptibility profiles with the need for broad-spectrum coverage. In addition, the concomitant presence of endocarditis and prosthetic joint infection presented a therapeutic dilemma regarding the prioritization of intervention. To date, the only other published case of concomitant endocarditis and PJI caused by Granulicatella was reported by Renz et al., in which both conditions were managed conservatively, with the DAIR approach being used for PJI [5]. In contrast, due to the inability to clearly establish the source and the interval between the primary focus of bacteremia and the onset of prosthetic joint infection, our patient underwent a two-stage exchange arthroplasty.
Our review has several limitations. First of all, the analysis is based exclusively on case reports, which inherently limits the reliability and generalizability of the findings. The reported outcomes and their correlation with variables such as antimicrobial regimen, treatment duration, and surgical strategy may be confounded by inconsistent or unreported follow-up periods. Moreover, the small sample size substantially limits statistical power. Nevertheless, there appears to be a trend suggesting improved outcomes with prolonged antibiotic therapy. Further studies with larger cohorts are warranted to better understand and define optimal management strategies for PJIs caused by A. defectiva and Granulicatella spp.
5. Conclusions
Our case illustrates a complex presentation of A. defectiva infection accompanied with a literature review on prosthetic joint infections caused by A. defectiva and Granulicatella spp. Although the available evidence is primarily derived from case reports—limiting its overall reliability—there appears to be an association between prolonged antibiotic treatment and improved clinical outcomes. This may reflect the fastidious nature of these organisms, which can contribute to persistent infection if not adequately treated.
Advances in microbiological diagnostics, including MALDI-TOF mass spectrometry and molecular techniques such as 16S rRNA gene PCR, have significantly enhanced the identification of fastidious pathogens. These technologies have facilitated the recognition of emerging microorganisms that were previously underdiagnosed, potentially reshaping the epidemiology of traditionally well-characterized infections such as prosthetic joint infections and endocarditis. Sharing clinical experiences in this field is crucial for improving our understanding of pathogen behavior and refining management strategies.
Author Contributions
C.S. conceived the manuscript and drafted the main version; E.P. provided the microbiological data related to the case; E.C. and A.F. contributed to the literature research; C.F. and C.Z. contributed to the analysis of the scientific literature, table formatting, and interpretation of the results; D.B., M.Z., M.C. and T.S. supervised the clinical management of the case; A.M., T.S. and P.C. supervised the overall preparation of the manuscript. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki.
Informed Consent Statement
The patient has given consent for the presentation of the clinical case report. The consent statement is available upon request to the corresponding author.
Data Availability Statement
The original contributions presented in this paper are included in the article (Appendix A). Further inquiries can be directed to the corresponding author.
Conflicts of Interest
The authors declare no conflicts of interest.
Abbreviations
The following abbreviations are used in this manuscript:
| NVS | Nutritionally variant streptococci |
| PJI | Prosthetic joint infection |
Appendix A
Table A1.
A summary of the literature on Granulicatella and Abiotrophia PJI.
Table A1.
A summary of the literature on Granulicatella and Abiotrophia PJI.
| Reference | Age | Sex | Comorbidity | Possible Risk Factor | Symptoms | Infected Joint | Bacteria | Endocarditis | Identification | Antibiogram | Pen-S |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Seguiti C et al. (our case, 2025); case report and literature review | 68 | M | diabetes; Barlow syndrome | urinary infection | fever; swelling | Prosthetic Knee | Abiotrophia defectiva | Yes (NVE mitral valve) | MALDI-TOF | No | NA |
| Ince A et al. (2002); case report [16] | 65 | F | alcoholism; diabetes; nephrectomy | NA | joint pain; swelling | Prosthetic Knee | Abiotrophia defectiva | No | 16S rRNA | No | NA |
| Cassir N et al. (2011); case report [17] | 71 | M | NA | dental procedure | swelling | Prosthetic Knee | Abiotrophia defectiva | No | 16S rRNA | Yes | Yes |
| Rozemejer W et al. (2011); case report [18] | 71 | F | polymialgia rheumatica | NA | joint pain | Prosthetic Hip | Abiotrophia defectiva | No | 16S rRNA | Yes | Yes |
| Mougari F et al. (2013); case report [19] | 55 | M | NA | dental procedure | joint pain; swelling | Prosthetic Knee | Granulicatella adiacens | No | 16S rRNA | Yes | Yes |
| Renz N et al. (2016); case report [5] | 69 | M | NA | dental procedure | fever; joint pain | Prosthetic Hip | Granulicatella para-adiacens | Yes (NVE mitral valve) | Culture + 16S rRNA | Yes | Intermediate |
| Aweid O et al. (2016); case report [20] | 81 | M | NA | dental procedure | fever; swelling | Prosthetic Hip | Granulicatella adiacens | No | MALDI-TOF | Yes | Yes |
| Pingili C et al. (2017); case report [21] | 64 | M | NA | dental procedure | swelling | Prosthetic Knee | Granulicatella adiacens | No | 16S rRNA | No | NA |
| Quénard F et al. (2017); case series (3 cases) [22] | 75 | M | hypertension; ankylosing spondylitis | dental procedure | fistula | Prosthetic Hip | Granulicatella adiacens | No | 16S rRNA | No | NA |
| 65 | M | alcoholism; psoriasis | NA | joint pain | Prosthetic Knee | Granulicatella adiacens | No | MALDI-TOF | No | NA | |
| 44 | F | congenital hip dysplasia | surgical resection of cystic lesion | joint pain; fistula | Prosthetic Hip | Granulicatella adiacens | No | MALDI-TOF + 16S rRNA | No | NA | |
| Mavrommati A B et al. (2017); case report [23] | 76 | F | NA | NA | joint pain | Prosthetic Knee | Granulicatella adiacens | No | Vitek 2 | Yes | NA |
| Tooley T R et al. (2019); case report [24] | 74 | M | cardiopathy; dysphagia; past PJI | NA | joint pain | Prosthetic Knee | Abiotrophia defectiva | No | MALDI-TOF | No | NA |
| Wan J et al. (2020); case report [25] | 65 | M | diabetes; hypertension; CKD | NA | joint pain; swelling | Prosthetic Knee | Abiotrophia defectiva | No | Culture | No | NA |
| Van Someren M W M et al. (2020); case report [26] | 61 | M | NA | NA | joint pain | Prosthetic Hip | Abiotrophia defectiva | No | Culture | Yes | No |
| Kocazeybek E et al. (2020); case report and literature review [27] | 69 | F | NA | dental procedure | joint pain; swelling | Prosthetic Knee | Abiotrophia defectiva | No | MALDI-TOF | Yes | Yes |
| Badrick T C et al. (2021); case report and literature review [28] | 79 | M | coronaropathy | dental procedure | joint pain | Prosthetic Hip | Granulicatella adiacens | No | 16S rRNA | No | NA |
| Narayana Murthy S et al. (2021); case report [29] | 65 | M | NA | acupuncture | joint pain; swelling | Prosthetic Knee | Granulicatella adiacens | No | Culture | No | NA |
| Young J N et al. (2022); case report [30] | 71 | M | Charcot–Marie–Tooth | left foot cellulitis; dental procedure | swelling | Prosthetic Knee | Abiotrophia defectiva | No | 16S rRNA | No | NA |
| Quirino A et al. (2022); case report and literature review [31] | 69 | F | NA | previous Staphylococcus warneri PJI | joint pain; swelling | Prosthetic Knee | Abiotrophia defectiva | No | MALDI-TOF; Vitek 2; 16S rRNA | Yes | Yes |
| Nooh A et al. (2025); case report [32] | 66 | F | hypertension; hypotiroidism; osteoporosis | urinary infection | joint pain; swelling | Prosthetic Knee | Abiotrophia defectiva | No | Culture | No | NA |
| Lovering E et al. (2025); case report [33] | 66 | F | prosthetic aortic valve | past Granulicatella adiacens bacteremia | swelling | Prosthetic Knee | Granulicatella adiacens | No | Vitek 2 | Yes | Intermediate |
NA: Not applicable (not specified).
Table A2.
A summary of the literature on the treatment of Granulicatella and Abiotrophia PJI and outcomes.
Table A2.
A summary of the literature on the treatment of Granulicatella and Abiotrophia PJI and outcomes.
| Reference | Surgical Option | Treatment Duration (Week) | Antibiotics | Outcome |
|---|---|---|---|---|
| Seguiti C et al. (our case, 2025); case report and literature review | two stage | 10 | vancomycin | Cured |
| Ince A et al. (2002); case report [16] | DAIR | 5 | cefazolin (10 d) + ciprofloxacin | Relapse (two stage) |
| Cassir N et al. (2011); case report [17] | two stage | 39 | amoxicillin | Cured |
| Rozemejer W et al. (2011); case report [18] | two stage | 6 | penicillin | Cured |
| Mougari F et al. (2013); case report [19] | two stage | 15 | amoxicillin + rifampin | Cured |
| Renz N et al. (2016); case report [5] | DAIR | 13 | penicillin + gentamycin (4 w) then levofloxacin + rifampin | Cured |
| Aweid O et al. (2016); case report [20] | DAIR | 6 | piperacillin/tazobactam + vancomycin + fucidic acid (4 w) then meropenem + daptomycin | Died from pneumonia |
| Pingili C et al. (2017); case report [21] | two stage | 6 | ertapenem | Cured |
| Quénard F et al. (2017); case series (3 cases) [22] | two stage | 26 | amoxicillin + clindamycin | Cured |
| one stage | 26 | clindamycin + rifampin | Cured | |
| DAIR | 26 | imipenem/cilastatin + ciprofloxacin (4 w) then amoxicillin/clavulanate + ciprofloxacin | Cured | |
| Mavrommati A B et al. (2017); case report [23] | two stage | NA | ciprofloxacin + rifampin | Cured |
| Tooley T R et al. (2019); case report [24] | two stage | 20 | ceftriaxone (6 w) then cephalexin | Cured |
| Wan J et al. (2020); case report [25] | two stage | 8 | vancomycin (2 w) then amoxicillin + rifampin | Cured |
| Van Someren M W M et al. (2020); case report [26] | two stage | 17 | ciprofloxacin (6 w) + clindamycin (17 w) | Cured |
| Kocazeybek E et al. (2020); case report and literature review [27] | two stage | 4 | penicillin + gentamycin | Cured |
| Badrick T C et al. (2021); case report and literature review [28] | two stage | 6 | benzylpenicillin | Cured |
| Narayana Murthy S et al. (2021); case report [29] | DAIR | NA | vancomycin (duration not specified) then clindamycin (6 w) | Cured |
| Young J N et al. (2022); case report [30] | two stage | 6 | ceftriaxone | Reinfection (Enterobacter cloacae) |
| Quirino A et al. (2022); case report and literature review [31] | retention | 9 | ampicillin + ceftriaxone (3 w) then amoxicillin + doxycyclin | Cured |
| Nooh A et al. (2025); case report [32] | two stage | 12 | ceftriaxone + teicoplanin (6 w) then oral therapy (not specified) | Cured |
| Lovering E et al. (2025); case report [33] | two stage | NA | vancomycin (total duration not specified) | Cured |
NA: Not applicable (not specified).
Table A3.
Descriptive and inferential statistics of potential features related to dichotomous outcome: not cured vs. cured.
Table A3.
Descriptive and inferential statistics of potential features related to dichotomous outcome: not cured vs. cured.
| Outcome: | Not Cured (N = 3) | Cured (N = 19) | p-Value |
|---|---|---|---|
| Age | |||
| Mean (SD) | 72.3 (8.08) | 66.9 (7.87) | 0.361 |
| Sex | |||
| F | 1 (33.3%) | 7 (36.8%) | 1 |
| M | 2 (66.7%) | 12 (63.2%) | |
| Diabetes_yes_no | |||
| No | 1 (50.0%) | 8 (80.0%) | 1 |
| Yes | 1 (50.0%) | 2 (20.0%) | |
| Dental procedure | |||
| No | 0 (0.0%) | 6 (46.0%) | 0.64 |
| Yes | 2 (100.0%) | 7 (53.0%) | |
| Infected joint | |||
| Prosthetic Hip | 1 (33.3%) | 6 (31.5%) | 1 |
| Prosthetic Knee | 2 (66.7%) | 13 (68.5%) | |
| Bacteria | |||
| Abiotrophia defectiva | 2 (66.7%) | 9 (47.4%) | 0.793 |
| Granulicatella adiacens | 1 (33.3%) | 9 (47.4%) | |
| Granulicatella para-adiacens | 0 (0%) | 1 (5.2%) | |
| Endocarditis | |||
| No | 3 (100%) | 17 (89.5%) | 1 |
| Yes (NVE mitral valve) | 0 (0%) | 2 (10.5%) | |
| Antibiogram | |||
| No | 2 (66.7%) | 10 (52.6%) | 1 |
| Yes | 1 (33.3%) | 9 (47.4%) | |
| Penicillin S | |||
| Intermediate | 0 (0%) | 2 (25.0%) | 0.755 |
| No | 0 (0%) | 1 (12.5%) | |
| Yes | 1 (33.3%) | 5 (62.5%) | |
| Surgical option | |||
| DAIR | 2 (66.7%) | 3 (15.7%) | 0.274 |
| One stage | 0 (0%) | 1 (5.3%) | |
| Retention | 0 (0%) | 1 (5.3%) | |
| Two stage | 1 (33.3%) | 14 (73.7%) | |
| Treatment duration, weeks | |||
| Mean (SD) | 5.67 (0.577) | 15.2 (9.85) | 0.048 |
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