Comparison of Microbiological Profiles of Primary Hip and Knee Peri-Prosthetic Joint Infections Treated at Specialist Centers Around the World

Periprosthetic joint infection (PJI) is a complex complication of total joint arthroplasty, with microbiological profiles varying across centers worldwide. However, most studies are limited to single-center or intra-country multicenter analyses, often including mixed cohorts of primary and revision...

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Main Authors: Emin Suha Dedeogullari, Pablo Slullitel, Isabel Horton, Bulent Atilla, Saif Salih, Paul Monk, Ahmet Mazhar Tokgozoglu, Michael Goplen, Bonita Tsang, Martin Buljubasich, Hesham Abdelbary, Simon Garceau, George Grammatopoulos
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Language:English
Published: MDPI AG 2025-06-01
Series:Microorganisms
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Online Access:https://www.mdpi.com/2076-2607/13/7/1505
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author Emin Suha Dedeogullari
Pablo Slullitel
Isabel Horton
Bulent Atilla
Saif Salih
Paul Monk
Ahmet Mazhar Tokgozoglu
Michael Goplen
Bonita Tsang
Martin Buljubasich
Hesham Abdelbary
Simon Garceau
George Grammatopoulos
author_facet Emin Suha Dedeogullari
Pablo Slullitel
Isabel Horton
Bulent Atilla
Saif Salih
Paul Monk
Ahmet Mazhar Tokgozoglu
Michael Goplen
Bonita Tsang
Martin Buljubasich
Hesham Abdelbary
Simon Garceau
George Grammatopoulos
author_sort Emin Suha Dedeogullari
collection DOAJ
description Periprosthetic joint infection (PJI) is a complex complication of total joint arthroplasty, with microbiological profiles varying across centers worldwide. However, most studies are limited to single-center or intra-country multicenter analyses, often including mixed cohorts of primary and revision PJI cases, with limited data regarding global antibiotic resistance patterns. This study compared the microbiological characteristics, polymicrobial culture rates, prevalence of culture-negative infections, and antibiotic resistance patterns in PJI cases across five referral centers from five continents. A total of 717 patients with primary hip and knee PJI were included from centers in Argentina, Canada, Turkey, England, and New Zealand. <i>Staphylococcus aureus</i> and <i>Staphylococcus epidermidis</i> were the most common pathogens (48.5%, <i>p</i> < 0.01). Culture-negative infection rates varied significantly, ranging from 4.2% (England) to 24.6% (Turkey) (<i>p</i> < 0.01). Polymicrobial infections were the most frequent in Canada (8.9%) and the least frequent in England (1.1%) (<i>p</i> < 0.01). Gram-negative bacteria comprised 13.1% of culture-positive cases, with no significant intercountry difference. Multidrug resistance was observed in all centers, ranging from 23.7% (Argentina) to 43.1% (Turkey), with no statistical significance. Vancomycin resistance was detected in England (2.3%) and Canada (1.2%) but absent in Turkey, New Zealand, and Argentina. These findings underscore significant intercontinental variability, emphasizing the need for regional considerations in regards to empiric antibiotic selection and PJI management.
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spelling doaj-art-cf1e0f943d534ccb8be5a4495df1e4512025-08-20T03:56:46ZengMDPI AGMicroorganisms2076-26072025-06-01137150510.3390/microorganisms13071505Comparison of Microbiological Profiles of Primary Hip and Knee Peri-Prosthetic Joint Infections Treated at Specialist Centers Around the WorldEmin Suha Dedeogullari0Pablo Slullitel1Isabel Horton2Bulent Atilla3Saif Salih4Paul Monk5Ahmet Mazhar Tokgozoglu6Michael Goplen7Bonita Tsang8Martin Buljubasich9Hesham Abdelbary10Simon Garceau11George Grammatopoulos12Hacettepe University Hospital, Hacettepe, A.Adnan Saygun Cd., 06230 Altindag, Ankara, TurkeyHospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, CABA, Buenos Aires 1199, ArgentinaThe Ottawa Hospital, 501 Smyth Rd., Ottawa, ON K1H 8L6, CanadaHacettepe University Hospital, Hacettepe, A.Adnan Saygun Cd., 06230 Altindag, Ankara, TurkeySheffield Teaching Hospitals, Northern General Hospital, Herries Road, Sheffield S5 7AU, UKAuckland City Hospital, 2 Park Road, Grafton, Auckland 1023, New ZealandHacettepe University Hospital, Hacettepe, A.Adnan Saygun Cd., 06230 Altindag, Ankara, TurkeyAuckland City Hospital, 2 Park Road, Grafton, Auckland 1023, New ZealandSheffield Teaching Hospitals, Northern General Hospital, Herries Road, Sheffield S5 7AU, UKHospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, CABA, Buenos Aires 1199, ArgentinaThe Ottawa Hospital, 501 Smyth Rd., Ottawa, ON K1H 8L6, CanadaThe Ottawa Hospital, 501 Smyth Rd., Ottawa, ON K1H 8L6, CanadaThe Ottawa Hospital, 501 Smyth Rd., Ottawa, ON K1H 8L6, CanadaPeriprosthetic joint infection (PJI) is a complex complication of total joint arthroplasty, with microbiological profiles varying across centers worldwide. However, most studies are limited to single-center or intra-country multicenter analyses, often including mixed cohorts of primary and revision PJI cases, with limited data regarding global antibiotic resistance patterns. This study compared the microbiological characteristics, polymicrobial culture rates, prevalence of culture-negative infections, and antibiotic resistance patterns in PJI cases across five referral centers from five continents. A total of 717 patients with primary hip and knee PJI were included from centers in Argentina, Canada, Turkey, England, and New Zealand. <i>Staphylococcus aureus</i> and <i>Staphylococcus epidermidis</i> were the most common pathogens (48.5%, <i>p</i> < 0.01). Culture-negative infection rates varied significantly, ranging from 4.2% (England) to 24.6% (Turkey) (<i>p</i> < 0.01). Polymicrobial infections were the most frequent in Canada (8.9%) and the least frequent in England (1.1%) (<i>p</i> < 0.01). Gram-negative bacteria comprised 13.1% of culture-positive cases, with no significant intercountry difference. Multidrug resistance was observed in all centers, ranging from 23.7% (Argentina) to 43.1% (Turkey), with no statistical significance. Vancomycin resistance was detected in England (2.3%) and Canada (1.2%) but absent in Turkey, New Zealand, and Argentina. These findings underscore significant intercontinental variability, emphasizing the need for regional considerations in regards to empiric antibiotic selection and PJI management.https://www.mdpi.com/2076-2607/13/7/1505periprosthetic joint infectionPJImicrobiological profilemicrobiological trendsantibiotic resistanceculture
spellingShingle Emin Suha Dedeogullari
Pablo Slullitel
Isabel Horton
Bulent Atilla
Saif Salih
Paul Monk
Ahmet Mazhar Tokgozoglu
Michael Goplen
Bonita Tsang
Martin Buljubasich
Hesham Abdelbary
Simon Garceau
George Grammatopoulos
Comparison of Microbiological Profiles of Primary Hip and Knee Peri-Prosthetic Joint Infections Treated at Specialist Centers Around the World
Microorganisms
periprosthetic joint infection
PJI
microbiological profile
microbiological trends
antibiotic resistance
culture
title Comparison of Microbiological Profiles of Primary Hip and Knee Peri-Prosthetic Joint Infections Treated at Specialist Centers Around the World
title_full Comparison of Microbiological Profiles of Primary Hip and Knee Peri-Prosthetic Joint Infections Treated at Specialist Centers Around the World
title_fullStr Comparison of Microbiological Profiles of Primary Hip and Knee Peri-Prosthetic Joint Infections Treated at Specialist Centers Around the World
title_full_unstemmed Comparison of Microbiological Profiles of Primary Hip and Knee Peri-Prosthetic Joint Infections Treated at Specialist Centers Around the World
title_short Comparison of Microbiological Profiles of Primary Hip and Knee Peri-Prosthetic Joint Infections Treated at Specialist Centers Around the World
title_sort comparison of microbiological profiles of primary hip and knee peri prosthetic joint infections treated at specialist centers around the world
topic periprosthetic joint infection
PJI
microbiological profile
microbiological trends
antibiotic resistance
culture
url https://www.mdpi.com/2076-2607/13/7/1505
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