14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
is available electronically on http://www.sciencedirect.com
Final Abstract Number: 25.009
Session: Clinical Bacterial Infections
Date: Wednesday, March 10, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
Prosthetic joint infections: A multidisciplinary approach (1992-2008)
C. A. Pensotti 1 , F. Nacinovich 2 , P. Fernandez Oses 3 , J. Thierer 4 , A. Ferraris 5 , C. Vizzotti 3 , C. Di
Stéfano 6 , D. Stamboulian 7
1 FUNCEI and Clinica Privada Monte Grande, Ciudad Autonoma de Buenos Aires, Argentina,
2 FUNCEI and ICBA, Ciudad Autonoma de Buenos Aires, Argentina, 3 FUNCEI, Ciudad Autonoma
de Buenos Aires, Argentina, 4 ICBA, Ciudad Autonoma de Buenos Aires, Argentina, 5 FUNCEI,
Ciudad Autónoma de Buenos Aires, Argentina, 6 FUNCEI , Ciudad Autonoma de Buenos Aires,
Argentina, 7 Clinical Director of FUNCEI, Ciudad Autonoma de Buenos Aires, Argentina
Background: The management of prosthetic joint infections (PJI) requires combined medical
treatment and surgery. The one or two-stage exchange arthroplasty (EA) or resection arthroplasty
(RA) are the conventional surgical approach suggested.
The objectiv was to analyze the clinical and microbiological features and the outcome of PJI
treated with the conventional surgery approach.
Methods: We performed a retrospective cohort study of PJI episodes (ep.) treated with EA or
RA. The medical and surgical approach were not previously standardized, but individualized
according to the patient and the treating team. Statistical analysis: we used the Stata 10, applying
the Chi 2 test. Difference was considered statistically significantatp50 mm/h: 66.3%.
Microbiology: 57.6% grampositive cocci (S. aureus 35.2%, CoNS 13.6%, other 9.2%), 10.4%
gramnegative bacilli (P. aeruginosa 8% Enterobacteriaceae 4%); polimicrobial 24%, fungi 1.6%,
anaerobic bacteria 0.8%, culture negative 5.6%.
Antibiotic therapy: TI: 20 weeks (median; IR 12-26); oral 50%, switch to oral therapy 37.5%,
parenteral only 12.5%.TS in 28,9% ep; median 24 weeks (IR 11-37).
Surgical treatment: two-stages EA 50.4%, one-stage EA 13.9%, AR 35.7%.
Follow up: 27 months (median; IR 16-50).
Outcome: cure/ improvement: 109 (87.2%), relapse 9 (7.2%), failure 3 (2.4%), not evaluable
(3.2%).
In the univariate analysis, only PJI treated with two-stages EA had a better outcome (p = 0.04).
Conclusion: The management of PJI should be individualized according to the patient
characteristics and evaluated with a team (orthopedic surgeons and infectologist). This is the key
in determining the functional status of the prosthesis, in order to define the surgery strategy. Twostages
EA is the method that achieves better control of infection. There were no significant
differences in the outcome with the others variables studied.