Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by <i>Pseudomonas aeruginosa</i> Compared to Other Gram-Negative Bacilli
<i>Pseudomonas aeruginosa</i> is considered as more difficult to treat than other Gram-negatives in patients with acute periprosthetic joint infections (PJIs). However, clinical data to support this hypothesis are lacking. This retrospective multicenter cohort study included 39 patients...
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2025-04-01
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| author | Wai-Yan Liu Johannes G. E. Hendriks Robin W. T. M. van Kempen Walter van der Weegen Wim H. C. Rijnen Jon H. M. Goosen Babette C. van der Zwaard Yvette Pronk Wierd P. Zijlstra Bas L. E. F. ten Have Joris J. W. Ploegmakers Marjan Wouthuyzen-Bakker |
| author_facet | Wai-Yan Liu Johannes G. E. Hendriks Robin W. T. M. van Kempen Walter van der Weegen Wim H. C. Rijnen Jon H. M. Goosen Babette C. van der Zwaard Yvette Pronk Wierd P. Zijlstra Bas L. E. F. ten Have Joris J. W. Ploegmakers Marjan Wouthuyzen-Bakker |
| author_sort | Wai-Yan Liu |
| collection | DOAJ |
| description | <i>Pseudomonas aeruginosa</i> is considered as more difficult to treat than other Gram-negatives in patients with acute periprosthetic joint infections (PJIs). However, clinical data to support this hypothesis are lacking. This retrospective multicenter cohort study included 39 patients with acute PJIs caused by <i>P. aeruginosa</i> and 84 control patients with another Gram-negative bacillus (i.e., Enterobacterales). Both groups were managed by surgical debridement, antibiotics, and implant retention (DAIR). Treatment failure within one-year follow-up was defined as prosthesis extraction, a clinical need for suppressive antibiotic treatment and/or PJI-related death. Distribution of affected joints, and revision versus primary arthroplasties, did not differ between groups. Most PJIs were polymicrobial (87% in cases, 81% in control patients, <i>p</i> = 0.451). Surgical and antibiotic management was similar between groups. Treatment failure did not differ between groups: 5/39 cases (12.8%) and 14/84 control patients (16.7%, <i>p</i> = 0.610). An acceptable success rate of acute PJI caused by <i>P. aeruginosa</i> when treated with DAIR was observed. This success rate did not differ compared to PJIs caused by Enterobacterales. Therefore, <i>P. aeruginosa</i> should not be considered a more difficult to treat microorganism compared to other Gram-negatives. No additional surgical or antimicrobial interventions are needed when patients can be treated with a fluoroquinolone. |
| format | Article |
| id | doaj-art-5e4ad65caf394c17ae7c8add14daa130 |
| institution | DOAJ |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj-art-5e4ad65caf394c17ae7c8add14daa1302025-08-20T03:13:45ZengMDPI AGMicroorganisms2076-26072025-04-0113490410.3390/microorganisms13040904Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by <i>Pseudomonas aeruginosa</i> Compared to Other Gram-Negative BacilliWai-Yan Liu0Johannes G. E. Hendriks1Robin W. T. M. van Kempen2Walter van der Weegen3Wim H. C. Rijnen4Jon H. M. Goosen5Babette C. van der Zwaard6Yvette Pronk7Wierd P. Zijlstra8Bas L. E. F. ten Have9Joris J. W. Ploegmakers10Marjan Wouthuyzen-Bakker11Department of Orthopaedic Surgery & Trauma, Catharina Hospital, 5623 EJ Eindhoven, The NetherlandsDepartment of Orthopaedic Surgery & Trauma, Máxima MC, 5631 BM Eindhoven, The NetherlandsDepartment of Orthopaedic Surgery & Trauma, Catharina Hospital, 5623 EJ Eindhoven, The NetherlandsSports & Orthopedics Research Center, Anna Hospital, 5664 EH Geldrop, The NetherlandsDepartment of Orthopaedic Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The NetherlandsDepartment of Orthopaedic Surgery, Sint Maartenskliniek, 6532 SZ Nijmegen, The NetherlandsDepartment of Orthopedics, Jeroen Bosch Hospital, 5223 GZ ’s-Hertogenbosch, The NetherlandsResearch Department of Orthopedic Surgery, Kliniek ViaSana, 5451 AA Mill, The NetherlandsDepartment of Orthopedic Surgery, Medical Center Leeuwarden, 8934 AD Leeuwarden, The NetherlandsDepartment of Orthopedics, Martini Hospital, 9728 NT Groningen, The NetherlandsDepartment of Orthopaedic Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands<i>Pseudomonas aeruginosa</i> is considered as more difficult to treat than other Gram-negatives in patients with acute periprosthetic joint infections (PJIs). However, clinical data to support this hypothesis are lacking. This retrospective multicenter cohort study included 39 patients with acute PJIs caused by <i>P. aeruginosa</i> and 84 control patients with another Gram-negative bacillus (i.e., Enterobacterales). Both groups were managed by surgical debridement, antibiotics, and implant retention (DAIR). Treatment failure within one-year follow-up was defined as prosthesis extraction, a clinical need for suppressive antibiotic treatment and/or PJI-related death. Distribution of affected joints, and revision versus primary arthroplasties, did not differ between groups. Most PJIs were polymicrobial (87% in cases, 81% in control patients, <i>p</i> = 0.451). Surgical and antibiotic management was similar between groups. Treatment failure did not differ between groups: 5/39 cases (12.8%) and 14/84 control patients (16.7%, <i>p</i> = 0.610). An acceptable success rate of acute PJI caused by <i>P. aeruginosa</i> when treated with DAIR was observed. This success rate did not differ compared to PJIs caused by Enterobacterales. Therefore, <i>P. aeruginosa</i> should not be considered a more difficult to treat microorganism compared to other Gram-negatives. No additional surgical or antimicrobial interventions are needed when patients can be treated with a fluoroquinolone.https://www.mdpi.com/2076-2607/13/4/904debridementtreatmentantibioticsoutcome |
| spellingShingle | Wai-Yan Liu Johannes G. E. Hendriks Robin W. T. M. van Kempen Walter van der Weegen Wim H. C. Rijnen Jon H. M. Goosen Babette C. van der Zwaard Yvette Pronk Wierd P. Zijlstra Bas L. E. F. ten Have Joris J. W. Ploegmakers Marjan Wouthuyzen-Bakker Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by <i>Pseudomonas aeruginosa</i> Compared to Other Gram-Negative Bacilli Microorganisms debridement treatment antibiotics outcome |
| title | Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by <i>Pseudomonas aeruginosa</i> Compared to Other Gram-Negative Bacilli |
| title_full | Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by <i>Pseudomonas aeruginosa</i> Compared to Other Gram-Negative Bacilli |
| title_fullStr | Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by <i>Pseudomonas aeruginosa</i> Compared to Other Gram-Negative Bacilli |
| title_full_unstemmed | Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by <i>Pseudomonas aeruginosa</i> Compared to Other Gram-Negative Bacilli |
| title_short | Clinical Outcome of Patients with Acute Periprosthetic Joint Infections Caused by <i>Pseudomonas aeruginosa</i> Compared to Other Gram-Negative Bacilli |
| title_sort | clinical outcome of patients with acute periprosthetic joint infections caused by i pseudomonas aeruginosa i compared to other gram negative bacilli |
| topic | debridement treatment antibiotics outcome |
| url | https://www.mdpi.com/2076-2607/13/4/904 |
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