Treatment of prosthetic joint infections due to Propionibacterium. Similar results in 60 patients treated with and without rifampicin

Acta Orthop. 2016 Feb;87(1):60-6. doi: 10.3109/17453674.2015.1094613. Epub 2015 Sep 28.

Abstract

Background and purpose: Currently, Propionibacterium is frequently recognized as a causative microorganism of prosthetic joint infection (PJI). We assessed treatment success at 1- and 2-year follow-up after treatment of Propionibacterium-associated PJI of the shoulder, hip, and knee. Furthermore, we attempted to determine whether postoperative treatment with rifampicin is favorable.

Patients and methods: We conducted a retrospective cohort study in which we included patients with a primary or revision joint arthroplasty of the shoulder, hip, or knee who were diagnosed with a Propionibacterium-associated PJI between November 2008 and February 2013 and who had been followed up for at least 1 year.

Results: We identified 60 patients with a Propionibacterium-associated PJI with a median duration of 21 (0.1-49) months until the occurrence of treatment failure. 39 patients received rifampicin combination therapy, with a success rate of 93% (95% CI: 83-97) after 1 year and 86% (CI: 71-93) after 2 years. The success rate was similar in patients who were treated with rifampicin and those who were not.

Interpretation: Propionibacterium-associated PJI treated with surgery in combination with long-term antibiotic administration had a successful outcome at 1- and 2-year follow-up irrespective of whether the patient was treated with rifampicin. Prospective studies are needed to determine whether the use of rifampicin is beneficial in the treatment of Propionibacterium-associated PJI.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Gram-Positive Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / drug therapy*
  • Hip Prosthesis / adverse effects
  • Humans
  • Kaplan-Meier Estimate
  • Knee Prosthesis / adverse effects
  • Male
  • Middle Aged
  • Netherlands
  • Propionibacterium / drug effects*
  • Propionibacterium / isolation & purification
  • Prosthesis Failure
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / microbiology*
  • Prosthesis-Related Infections / surgery
  • Reference Values
  • Reoperation / methods
  • Retrospective Studies
  • Rifampin / therapeutic use*
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Rifampin