Author/Editor		Tornero, Eduard; Senneville, Eric; Euba, Gorane; Petersdorf, Sabine; Lakatos, Botond; Pilares, Martín; Ferrari, Mateo Carlo; Bahamonde, Alberto; Trebše, Rihard; Benito, Natividad
Title		Characteristics of prosthetic joint infections due to Enterococcus sp. and predictors of failure
Type		članek
Vol. and No.		Letnik 20, št. 11
Publication year		2014
Volume		str. 1219-1224
ISSN		1469-0691 - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
Language		eng
Abstract		The objective of this study was to review the characteristics and outcome of prosthetic joint infections (PJI) due to Enterococcus sp collected in 18 hospitals from 6 European countries. Patients with a PJI due to Enterococcus sp diagnosed between January 1999 and July 2012 were retrospectively reviewed. Relevant information about demographics, co-morbidity, clinical characteristics, microbiological data, surgical treatment and outcome was registered. Uni- and multivariable analyses were performed. A total of 203 patients met the inclusion criteria. The mean (SD) was 70.4 (13.6) years. In 59 cases the infection was diagnosed within the first 30 days (29.1%) from arthroplasty, in 44 (21.7%) between 31-90 days, in 54 (26.6%) between 91 days and 2 years and in 43 (21%) after 2 years. Enterococcus faecalis was isolated in 176 cases (89%). In 107 (54%) patients the infection was polymicrobial. Any co-morbidity (OR: 2.53, CI95%: 1.18-5.40, P=0.01), and fever (OR: 2.65, CI95%: 1.23-5.69, P=0.01) were independently associated with failure. The only factor associated with remission was infections diagnosed later than 2 years (OR: 0.25, CI95%: 0.09-0.71, P=0.009). In conclusion, prosthetic joint infections due to Enterococcus sp were diagnosed within the first 2 years from arthroplasty in >70% of the cases, almost 50% had %1 co-morbidity and were frequently polymicrobial infections (54%). The global failure rate was 44% and patients with co-morbidities, fever, and diagnosed within the first 2 years from arthroplasty had a poor prognosis.
Keywords		prosthetic joint infection Enterococcus faecalis Enterococcus faecium debridement one-stage exchange two-stage exchange outcome