Articles | Volume 11, issue 1
https://doi.org/10.5194/jbji-11-83-2026
https://doi.org/10.5194/jbji-11-83-2026
Original full-length article
 | 
10 Feb 2026
Original full-length article |  | 10 Feb 2026

High failure rate in Pseudomonas aeruginosa-associated periprosthetic hip and knee joint infections

Ece Akcicek, Jennyfer A. Mitterer, Veronika Achatz, Tamino Szirmay, Sujeesh Sebastian, and Jochen G. Hofstaetter

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Proteus-species-associated periprosthetic hip and knee joint infections – a 15-year cohort analysis
Veronika Achatz, Jennyfer A. Mitterer, Stephanie Huber, Ece Akcicek, Selma Tobudic, Sujeesh Sebastian, and Jochen G. Hofstaetter
J. Bone Joint Infect., 10, 265–275, https://doi.org/10.5194/jbji-10-265-2025,https://doi.org/10.5194/jbji-10-265-2025, 2025
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Cited articles

Abdi-Ali, A., Mohammadi-Mehr, M., and Agha Alaei, Y.: Bactericidal activity of various antibiotics against biofilm-producing Pseudomonas aeruginosa, Int. J. Antimicrob. Agents, 27, 196–200, https://doi.org/10.1016/J.IJANTIMICAG.2005.10.007, 2006. 
Achatz, V., Mitterer, J. A., Huber, S., Akcicek, E., Tobudic, S., Sebastian, S., and Hofstaetter, J. G.: Proteus-species-associated periprosthetic hip and knee joint infections – a 15-year cohort analysis, J. Bone Joint Infect., 10, 265–275, https://doi.org/10.5194/jbji-10-265-2025, 2025. 
Akgün, D., Müller, M., Perka, C., and Winkler, T.: Positive bacterial culture during re-implantation is associated with a poor outcome in two-stage exchange arthroplasty for deep infection, Bone Joint J., 99–1490, https://doi.org/10.1302/0301-620X.99B11.BJJ-2017-0243-R1, 2017. 
Anderl, J. N., Franklin, M. J., and Stewart, P. S.: Role of Antibiotic Penetration Limitation in Klebsiella pneumoniae Biofilm Resistance to Ampicillin and Ciprofloxacin, Antimicrob. Agents Chemother., 44, 1818–1824, https://doi.org/10.1128/aac.44.7.1818-1824.2000, 2000.  
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Short summary
Pseudomonas aeruginosa is a common pathogen in Gram-negative periprosthetic joint infections (PJIs). It is resistant to many antibiotics and forms biofilm, making it difficult to treat. We analyzed 1286 patients who underwent 1640 surgeries; among them, 38 patients with 50 procedures had P. aeruginosa. Most infections were chronic, often in hip revisions, with a high failure rate and recurrence. Due to its clinical and microbiological features, P. aeruginosa-related PJIs remain challenging.

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