Abstract
The objective was to determine most common pathogens causing periprosthetic joint infection (PJI) of major joints, to identify the tendency to antibiotic resistance over the period from 2015 to 2020. Material and methods Microbiological culture results of 354 patients with PJI of major joints treated at our department were retrospectively analyzed. The spectrum of the leading pathogens causing PJI and the antibacterial resistance were explored and the prevalence of common organisms depending on the type of PJI demonstrated. Results 354 patients were examined and 317 microbial isolates identified. Gram-positive bacteria was isolated in 70.7 % (224 microorganisms) of cases, Gram-negative bacilli isolated in 28.1 % (89 organisms) and Candida sp. identified in 1.2 % (4 isolates). Microbial associations were identified in 15% of cases. Discussion Most common pathogens causing PJI included S. aureus identified in 31.9 %; S. epidermidis, in 20.2 %; E. faecalis, in 8.5 %; P. aeruginosa, in 7.9 %; A. baumannii, in 7.3%. PJI associated MRSE strains increased from 12.1 % to 26.7 % and S. haemolyticus (MR) increased from 2 % to 11.6 %. S. aureus and Gram-negative bacilli were most common for early acute and hematogenous acute PJI. There were no significant differences in the prevalence of S. aureus and S. epidermidis in early/delayed and late chronic PJI. Enterococcus species and Gram-negative bacilli were detected less frequently with PJI. There was an increasing antibiotic resistance of A. baumannii and P. aeruginosa. Vancomycin-resistant strains and linezolid-resistant strains were newly found among Grampositive bacilli and pan drug-resistant A. baumannii strains. Conclusion The six-year microbiological monitoring showed S. aureus, S. epidermidis, P. aeruginosa, and A. baumannii as most common pathogens causing PJI. The growing antibiotic resistance of Gram-positive and Gram-negative bacilli and the increasing role of the latter in the pathogenesis of early acute PJI require changes in empirical antibiotic therapy regimens.
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