Outcome of penicillin-susceptible streptococcal prosthetic joint infection treated with debridement and retention of the prosthesis

Clin Infect Dis. 2003 Apr 1;36(7):845-9. doi: 10.1086/368182. Epub 2003 Mar 20.

Abstract

Debridement with retention of the prosthesis was the initial treatment modality for 19 cases of penicillin-susceptible streptococcal prosthetic joint infection that occurred in 18 patients who presented to the Mayo Clinic (Rochester, Minnesota) during 1969-1998. All of the cases of prosthetic joint infection occurred >30 days after implantation of the prosthesis, which was well fixed at the time of debridement. The median duration of symptoms before debridement was 4 days (range, 1-10 days). Treatment failure (defined as relapse of infection with the original microorganism) occurred in 2 cases (10.5%) during a median follow-up period of 3.9 years (range, 0.3-21.7 years). The 1-year cumulative risk of relapse was 11% (95% confidence interval, 0%-26%). Relapse of prosthetic joint infection due to penicillin-susceptible streptococci after debridement and retention of the prosthesis is uncommon. For patients who present with a well-fixed prosthesis and a short duration of symptoms, debridement with retention appears to be an effective treatment modality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cohort Studies
  • Debridement*
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Penicillins / pharmacology
  • Penicillins / therapeutic use
  • Prostheses and Implants
  • Prosthesis-Related Infections / drug therapy
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / surgery*
  • Retrospective Studies
  • Risk Factors
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / microbiology
  • Streptococcal Infections / surgery*
  • Streptococcus* / drug effects
  • Treatment Failure

Substances

  • Penicillins