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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 3, issue 5
J. Bone Joint Infect., 3, 241–244, 2018
https://doi.org/10.7150/jbji.25887
© Author(s) 2018. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 3, 241–244, 2018
https://doi.org/10.7150/jbji.25887
© Author(s) 2018. This work is distributed under
the Creative Commons Attribution 4.0 License.

Original full-length article 31 Oct 2018

Original full-length article | 31 Oct 2018

Totally Implantable Venous-Access Device Infection Causing Hematogenous Prosthetic Joint Infection: A Retrospective Case Series

Fernanda Medina1, Vanina Meyssonnier1,2, Valérie Zeller1,2, Beate Heym1,3, Jean-Marc Ziza1,2, and Simon Marmor1,4 Fernanda Medina et al.
  • 1Bone-and-Joint Infections Referral Center, Hôpital Croix Saint-Simon, 125, rue d'Avron 75020 Paris, France
  • 2Internal Medicine Department, Hôpital Croix Saint-Simon, 125, rue d'Avron 75020 Paris, France
  • 3Microbiology Department, Hôpital Croix Saint-Simon, 125, rue d'Avron 75020 Paris, France
  • 4Orthopedic Surgery Department, Hôpital Croix Saint-Simon, 125, rue d'Avron 75020 Paris, France

Keywords: prosthetic joint infection, hematogenous dissemination, catheter infection.

Abstract. Introduction: Prosthetic joint infections (PJIs) can be acquired hematogenously from a distant site or device. Notably, 30%-40% of patients with PJIs have Staphylococcus aureus bacteremia. No case reports or series of PJIs acquired from totally implantable venous-access device (TIVAD) infection or colonization have been published. This study was undertaken to describe epidemiological, clinical, microbiological and radiological characteristics of such PJIs, their treatments and outcomes.

Methods: This retrospective study included all patients, identified in a prospective French Bone-and-Joint Infections Referral Center cohort treated between 2004 and 2017, with PJI secondary to TIVAD infection, with the same microbiologically documented microorganism isolated from both.

Results: We describe six consecutive hematogenous PJIs (4 women, 2 men; median age: 66.5 years) acquired from TIVAD primary infections. The main infection risk factors were malignancy (n=5) and prior septic arthritis (n=2). Four participants' TIVADs were implanted for chemotherapy, preceding the prosthesis for one patient. The median TIVAD-implantation-to-symptom-onset interval was 12 months. Microorganisms were Staphylococcus epidermidis (n=4), Staphylococcus capitis (n=1) and Staphylococcus aureus (n=1). All TIVADs were removed. Five participants received curative treatment, with a median of 12 weeks of antibiotics. After median follow-up of 42 months, none have relapsed.

Conclusions: When PJI occurs in a patient with a TIVAD, the latter must be tested as a potential source of the prosthesis infection. Conversely, PJIs must sought in all patients with bacteremia.

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