Lydia Speijker

Radboud University Nijmegen

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Wim H. C. Rijnen

Radboud University Nijmegen

Matthijs P. Somford

Rijnstate Hospital

Ianthe Maat

National Institute for Public Health and the Environment

Ilse J.E. Kouijzer

Radboud University Nijmegen

Jaap ten Oever

Radboud University Nijmegen

Erik H.J.G. Aarntzen

Radboud University Nijmegen

Maurits van Meer

Rijnstate Hospital

Jet Gisolf

Rijnstate Hospital

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Radboud University Nijmegen

Radboud University Medical Center

University Medical Center

Rijnstate Hospital

Radboud Institute for Molecular Life Sciences

University Medical Center Groningen

University of Groningen

National Institute for Public Health and the Environment

Dutch Heart Registry

Clinical Orthopaedics and Related Research

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Clinically unsuspected orthopedic implants during S. aureus bacteremia do not require additional diagnostic work-up

Research Square (Research Square) (2022)

Ilse J.E. Kouijzer Lydia Speijker Erik H.J.G. Aarntzen Wim H. C. Rijnen Matthijs P. Somford

Abstract Purpose To assess the likelihood of occult infection in patients with clinically unsuspected orthopedic implants during Staphylococcus aureus bacteremia (SAB). Methods In a retrospective study in two Dutch hospitals, we included all patients with SAB between 2013 and 2020 with one or more orthopedic implants in whom [ 18 F]FDG-PET/CT was performed. The primary outcome was the percentage of patients who had an infected orthopedic implant by S. aureus . Also, we compared the clinical parameters of infected and uninfected orthopedic implants. Results Fifty-five of 191 (29%) orthopedic implants in 118 SAB patients included had clinical signs of infection. Of all 136 unsuspected implants, 5 (3%, all arthroplasties), showed increased [ 18 F]FDG uptake around the prosthesis on [ 18 F]FDG-PET/CT. The clinical course of these patients without clinically overt infection or relapse of bacteremia during follow-up of a median of 48 months (range 0–48), however, argued against prosthetic joint infection. Conclusion Although orthopedic implants are evidently a risk factor for metastatic infection during SAB, the absence of clinical symptoms obviate the need of additional investigations or prolonged antibiotic treatment.

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Bacteremia

10.21203/rs.3.rs-1849126/v1

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