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Article

Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study

by 1, 2, 3, 4, 5,6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17,18, 19, 20, 7, 1,21 and 1,21,* on behalf of the Bone and Joint Infection Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEIO-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI)
1
Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain
2
Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
3
Department of Infectious Diseases, Hospital Universitario de Basurto, 48013 Bilbao, Spain
4
Department of Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain
5
Department of Infectious Diseases, Hospital Universitario Donostia, Universidad del País Vasco (EHU/UPV), 20014 San Sebastián, Spain
6
IIS BioDonostia, 20014 San Sebastián, Spain
7
Infectious Diseases Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
8
Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
9
Department of Infectious Diseases, Hospital del Mar, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain
10
Department of Internal Medicine, Hospital El Bierzo, 24411 Ponferrada, Spain
11
Fundació Institut d’Investigació Sanitària Illes Balears, Hospital Universitari Son Espases, 07120 Palma, Spain
12
Unit of Infectious Diseases and Clinical Microbiology, Hospital Universitario La Paz, 28046 Madrid, Spain
13
Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena, Department of Medicine, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBiS), 41009 Seville, Spain
14
Department of Infectious Diseases, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, 08036 Barcelona, Spain
15
Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
16
Department of Infectious Diseases, Hospital Universitari Parc Taulí, 08208 Sabadell, Spain
17
Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau- Institut d’Investigació Biomèdica Sant Pau, 08025 Barcelona, Spain
18
Department of Medicine, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
19
Unit of Infectious Diseases, Department of Internal Medicine, Hospital Universitario Puerta de Hierro, 28220 Madrid, Spain
20
Territorial Unit of Nosocomial Infections, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain
21
Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), 41071 Sevilla, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Nicholas Dixon
Antibiotics 2021, 10(2), 118; https://doi.org/10.3390/antibiotics10020118
Received: 30 December 2020 / Revised: 19 January 2021 / Accepted: 22 January 2021 / Published: 26 January 2021
Objectives: To compare the characteristics and outcomes of cases with acute prosthetic joint infection (PJI; early post-surgical or hematogenous) by Staphylococcus aureus managed with implant removal (IRm) or debridement and retention (DAIR). To analyze the outcomes of all cases managed with IRm (initially or after DAIR failure). Methods: Retrospective, multicenter, cohort study of PJI by S. aureus (2003–2010). Overall failure included mortality within 60 days since surgery and local failure due to staphylococcal persistence/relapse. Results: 499 cases, 338 initially managed with DAIR, 161 with IRm. Mortality was higher in acute PJI managed initially with IRm compared to DAIR, but not associated with the surgical procedure, after propensity score matching. Underlying conditions, hemiarthroplasty, and methicillin-resistant S. aureus were risk factors for mortality. Finally, 249 cases underwent IRm (88 after DAIR failure); overall failure was 15.6%. Local failure (9.3%) was slightly higher in cases with several comorbidities, but independent of previous DAIR, type of IRm, and rifampin treatment. Conclusions: In a large multicenter study of S. aureus PJI managed with IRm, failure was low, but mortality significant, especially in cases with acute PJI and underlying conditions, but not associated with the IRm itself. Rifampin efficacy was limited in this setting. View Full-Text
Keywords: Staphylococcus aureus; prosthetic joint infection; implant removal; outcome; rifampin Staphylococcus aureus; prosthetic joint infection; implant removal; outcome; rifampin
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MDPI and ACS Style

Gómez-Junyent, J.; Lora-Tamayo, J.; Baraia-Etxaburu, J.; Sánchez-Somolinos, M.; Iribarren, J.A.; Rodriguez-Pardo, D.; Praena-Segovia, J.; Sorlí, L.; Bahamonde, A.; Riera, M.; Rico, A.; del Toro, M.D.; Morata, L.; Cobo, J.; Falgueras, L.; Benito, N.; Muñez, E.; Jover-Sáenz, A.; Pigrau, C.; Ariza, J.; Murillo, O., on behalf of the Bone and Joint Infection Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEIO-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI). Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study. Antibiotics 2021, 10, 118. https://doi.org/10.3390/antibiotics10020118

AMA Style

Gómez-Junyent J, Lora-Tamayo J, Baraia-Etxaburu J, Sánchez-Somolinos M, Iribarren JA, Rodriguez-Pardo D, Praena-Segovia J, Sorlí L, Bahamonde A, Riera M, Rico A, del Toro MD, Morata L, Cobo J, Falgueras L, Benito N, Muñez E, Jover-Sáenz A, Pigrau C, Ariza J, Murillo O on behalf of the Bone and Joint Infection Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEIO-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI). Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study. Antibiotics. 2021; 10(2):118. https://doi.org/10.3390/antibiotics10020118

Chicago/Turabian Style

Gómez-Junyent, Joan, Jaime Lora-Tamayo, Josu Baraia-Etxaburu, Mar Sánchez-Somolinos, Jose A. Iribarren, Dolors Rodriguez-Pardo, Julia Praena-Segovia, Luisa Sorlí, Alberto Bahamonde, Melchor Riera, Alicia Rico, Mª D. del Toro, Laura Morata, Javier Cobo, Luis Falgueras, Natividad Benito, Elena Muñez, Alfredo Jover-Sáenz, Carles Pigrau, Javier Ariza, and Oscar Murillo on behalf of the Bone and Joint Infection Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEIO-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI). 2021. "Implant Removal in the Management of Prosthetic Joint Infection by Staphylococcus aureus: Outcome and Predictors of Failure in a Large Retrospective Multicenter Study" Antibiotics 10, no. 2: 118. https://doi.org/10.3390/antibiotics10020118

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