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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 1, issue 1
J. Bone Joint Infect., 1, 25–30, 2016
https://doi.org/10.7150/jbji.15722
© Author(s) 2016. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 1, 25–30, 2016
https://doi.org/10.7150/jbji.15722
© Author(s) 2016. This work is distributed under
the Creative Commons Attribution 4.0 License.

Original full-length article 04 Jun 2016

Original full-length article | 04 Jun 2016

Pseudomonas Prosthetic Joint Infections: A Review of 102 Episodes

Neel B. Shah1, Douglas R. Osmon1, James M. Steckelberg1, Rafael J. Sierra2, Randall C. Walker1, Aaron J. Tande1, and Elie F. Berbari1 Neel B. Shah et al.
  • 1Department of Internal Medicine and Division of Infectious Disease, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA.
  • 2Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA.

Keywords: prosthetic joint infection, Pseudomonas, arthroplasty, debridement and implant retention.

Abstract. Background: The outcome of patients with Pseudomonas prosthetic joint infection (PS PJI) has not been well studied. The aim of this retrospective cohort study was to assess the outcome of patients with Pseudomonas PJI and to review risk factors associated with failure of therapy.

Methods: Between 1/1969 and 12/2012, 102 episodes of PS PJI in 91 patients were identified.

Results: The mean age at the time of diagnosis was 67.4 years; forty three percent had knee involvement. Over 40 percent had either diabetes mellitus or a history of gastrointestinal or genitourinary surgery. Nearly half (48 out of 102 episodes) received aminoglycoside monotherapy, while 25% received an anti-pseudomonal cephalosporin. The 2-year cumulative survival free from failure was 69% (95% CI, 56%-82%). Patients treated with resection arthroplasty, two-stage exchange, and debridement with implant retention had a 2-year cumulative survival free from failure of 80% (95% CI, 66%-95%), 83% (95% CI, 60%-100%), and 26% (95% CI, 23%-29%) respectively (P=0.0001).

Conclusions: PS PJI's are associated with a high failure rate. Patients treated with debridement and implant retention had a worse outcome.

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