International Organism Profile of Periprosthetic Total Hip and Knee Infections

Abstract Introduction There is scarce literature describing pathogens responsible for periprosthetic-joint-infections (PJI) around the world. Therefore, we sought to describe PJI causative organisms, rates of resistant organisms, and polymicrobial infections at 7 large institutions located in North/South America, and Europe. Methods We performed a retrospective study of 654 periprosthetic hip (n=361) and knee (n=293) infections (January2006-October2019) identified at Cleveland Clinic Ohio/Florida in the United States (US) (n=159), Hospital Italiano de Buenos Aires in Argentina (n=99), Hospital Asociacion Espanola in Uruguay (n=130), Guys and St Thomas’ Hospital in the United Kingdom (UK) (n=103), HELIOS Klinikum in Germany (n=59), and Vreden Institute for Orthopedics in St. Petersburg, Russia (n=104). Analyses were performed for the entire cohort, knees, and hips. Alpha was set at 0.05. Results Overall, the most frequent organisms identified were Staphylococcus aureus (24.8%) and epidermidis (21.7%). The incidence of organisms resistant to at least one antibiotic was 58% and there was a significant difference between hips (62.3%) and knees (52.6%) (p=0.014). Rates of resistant organisms among countries were: 37.7%-US, 66.7%-Argentina, 71.5%-Uruguay, 40.8%-UK, 62.7%-Germany, and 77.9%-Russia (p Conclusion In the evaluated institutions, Staphylococcus aureus and Staphylococcus epidermidis accounted for almost 50% of all infections. The United States and the United Kingdom had the lowest incidence of resistant organisms while Germany and Russia had the highest. The United Kingdom and Uruguay had the lowest rates of polymicrobial infections.