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Prosthetic joint infection diagnosis applying the three-level European Bone and Joint Infection Society (EBJIS) approach

Sensitive and specific tests for the diagnosis of prosthetic joint infection (PJI) are lacking. The aim of this study was to report clinical and microbiological findings of consecutive patients diagnosed with PJI at the University Hospital of Perugia, Perugia, Italy, and to validate these diagnoses...

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Autores principales: Papalini, Chiara, Pucci, Giacomo, Cenci, Giulia, Mencacci, Antonella, Francisci, Daniela, Caraffa, Auro, Antinolfi, Pierluigi, Pasticci, Maria Bruna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9033695/
https://www.ncbi.nlm.nih.gov/pubmed/35318542
http://dx.doi.org/10.1007/s10096-022-04410-x
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author Papalini, Chiara
Pucci, Giacomo
Cenci, Giulia
Mencacci, Antonella
Francisci, Daniela
Caraffa, Auro
Antinolfi, Pierluigi
Pasticci, Maria Bruna
author_facet Papalini, Chiara
Pucci, Giacomo
Cenci, Giulia
Mencacci, Antonella
Francisci, Daniela
Caraffa, Auro
Antinolfi, Pierluigi
Pasticci, Maria Bruna
author_sort Papalini, Chiara
collection PubMed
description Sensitive and specific tests for the diagnosis of prosthetic joint infection (PJI) are lacking. The aim of this study was to report clinical and microbiological findings of consecutive patients diagnosed with PJI at the University Hospital of Perugia, Perugia, Italy, and to validate these diagnoses utilizing the European Bone and Joint Infection Society (EBJIS) three-level diagnostic approach from 2021. Patients with a PJI diagnosis were included in this study and examined retrospectively. Overall, 133 patients were diagnosed with PJI: mean age 72 years, 54.9% female, and 55.6% with more than one comorbidity. The most frequent involved joints were hip 47% and knee 42%. Aetiology was identified in 88/133 (66.2%): staphylococci resulted the most frequent microorganisms and over 80% (45/54) resulted rifampin susceptible. Applying the EBJIS approach, PJI diagnosis resulted: confirmed in 101 (75.9%), likely in 25 (18.8%), and unlikely in 7 (5.3%). Likely PJIs aetiology was Staphylococcus aureus 11/25, coagulase-negative staphylococci 8/25, Streptococcus agalactiae 3/25, viridans group streptococci 2/25, and Pseudomonas aeruginosa 1/25. No statistically significant differences were detected among the three diagnosis groups with regard to clinical characteristics with the exception of a higher number of confirmed PJIs occurring < 3 months after implantation. The logistic regression analysis did not disclose any independent predictor of confirmed PJIs. We recommend using all the diagnostic tests available to approach PJI diagnosis, and suggest caution before rejecting PJI diagnosis in the presence of highly virulent microorganisms from a single sample, in patients without sinus tract, and in those receiving antimicrobial at the time microbiologic samples are collected. Study approved by Umbrian Regional Ethical Committee, Perugia, Italy, Prot. N. 23,124/21/ON of 10.27.2021.
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spelling pubmed-90336952022-05-06 Prosthetic joint infection diagnosis applying the three-level European Bone and Joint Infection Society (EBJIS) approach Papalini, Chiara Pucci, Giacomo Cenci, Giulia Mencacci, Antonella Francisci, Daniela Caraffa, Auro Antinolfi, Pierluigi Pasticci, Maria Bruna Eur J Clin Microbiol Infect Dis Original Article Sensitive and specific tests for the diagnosis of prosthetic joint infection (PJI) are lacking. The aim of this study was to report clinical and microbiological findings of consecutive patients diagnosed with PJI at the University Hospital of Perugia, Perugia, Italy, and to validate these diagnoses utilizing the European Bone and Joint Infection Society (EBJIS) three-level diagnostic approach from 2021. Patients with a PJI diagnosis were included in this study and examined retrospectively. Overall, 133 patients were diagnosed with PJI: mean age 72 years, 54.9% female, and 55.6% with more than one comorbidity. The most frequent involved joints were hip 47% and knee 42%. Aetiology was identified in 88/133 (66.2%): staphylococci resulted the most frequent microorganisms and over 80% (45/54) resulted rifampin susceptible. Applying the EBJIS approach, PJI diagnosis resulted: confirmed in 101 (75.9%), likely in 25 (18.8%), and unlikely in 7 (5.3%). Likely PJIs aetiology was Staphylococcus aureus 11/25, coagulase-negative staphylococci 8/25, Streptococcus agalactiae 3/25, viridans group streptococci 2/25, and Pseudomonas aeruginosa 1/25. No statistically significant differences were detected among the three diagnosis groups with regard to clinical characteristics with the exception of a higher number of confirmed PJIs occurring < 3 months after implantation. The logistic regression analysis did not disclose any independent predictor of confirmed PJIs. We recommend using all the diagnostic tests available to approach PJI diagnosis, and suggest caution before rejecting PJI diagnosis in the presence of highly virulent microorganisms from a single sample, in patients without sinus tract, and in those receiving antimicrobial at the time microbiologic samples are collected. Study approved by Umbrian Regional Ethical Committee, Perugia, Italy, Prot. N. 23,124/21/ON of 10.27.2021. Springer Berlin Heidelberg 2022-03-22 2022 /pmc/articles/PMC9033695/ /pubmed/35318542 http://dx.doi.org/10.1007/s10096-022-04410-x Text en © The Author(s) 2022, corrected publication 2022 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Papalini, Chiara
Pucci, Giacomo
Cenci, Giulia
Mencacci, Antonella
Francisci, Daniela
Caraffa, Auro
Antinolfi, Pierluigi
Pasticci, Maria Bruna
Prosthetic joint infection diagnosis applying the three-level European Bone and Joint Infection Society (EBJIS) approach
title Prosthetic joint infection diagnosis applying the three-level European Bone and Joint Infection Society (EBJIS) approach
title_full Prosthetic joint infection diagnosis applying the three-level European Bone and Joint Infection Society (EBJIS) approach
title_fullStr Prosthetic joint infection diagnosis applying the three-level European Bone and Joint Infection Society (EBJIS) approach
title_full_unstemmed Prosthetic joint infection diagnosis applying the three-level European Bone and Joint Infection Society (EBJIS) approach
title_short Prosthetic joint infection diagnosis applying the three-level European Bone and Joint Infection Society (EBJIS) approach
title_sort prosthetic joint infection diagnosis applying the three-level european bone and joint infection society (ebjis) approach
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9033695/
https://www.ncbi.nlm.nih.gov/pubmed/35318542
http://dx.doi.org/10.1007/s10096-022-04410-x
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