Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative Study
This study aims to investigate (1) microbial patterns in fracture-related infections (FRIs) in comparison to microbiological patterns of periprosthetic joint infections (PJIs), (2) the identification of effective empiric antibiotic therapy for FRIs and PJIs and (3) analysis of difficult-to-treat (DT...
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MDPI AG
2021-07-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/8/921 |
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| author | Markus Rupp Susanne Baertl Nike Walter Florian Hitzenbichler Martin Ehrenschwender Volker Alt |
| author_facet | Markus Rupp Susanne Baertl Nike Walter Florian Hitzenbichler Martin Ehrenschwender Volker Alt |
| author_sort | Markus Rupp |
| collection | DOAJ |
| description | This study aims to investigate (1) microbial patterns in fracture-related infections (FRIs) in comparison to microbiological patterns of periprosthetic joint infections (PJIs), (2) the identification of effective empiric antibiotic therapy for FRIs and PJIs and (3) analysis of difficult-to-treat (DTT) pathogens. Patients treated for FRIs or PJIs from 2017 to 2020 were evaluated for pathogens detected during treatment. Antibiotic susceptibility profiles were examined with respect to broadly used antibiotics and antibiotic combinations. Resistance rates to rifampicin or fluoroquinolone were determined. A total of 81 patients with PJI and 86 with FRI were included in the study. For FRIs <i>Staphylococcus aureus</i> was the most common infection-causing pathogen (37.4% vs. 27.9% for PJI). Overall, there was no statistical difference in pathogen distribution (<i>p</i> = 0.254). For FRIs, combinations of gentamicin + vancomycin (93.2%), co-amoxiclav + glycopeptide and meropenem + vancomycin (91.9% each) would have been effective for empiric therapy, similar to PJIs. Difficult to treat pathogens were more frequently detectable in PJIs (11.6% vs. 2.3%). Empiric therapy combinations such as gentamicin + vancomycin, co-amoxiclav + glycopeptide or meropenem + vancomycin, are effective antibiotic strategies for both FRI and PJI patients. More DTT pathogens were detectable in PJIs compared to FRIs. |
| first_indexed | 2024-03-10T09:04:40Z |
| format | Article |
| id | doaj.art-c94c6ddfa34341a6bffb7628e8e4fc24 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T09:04:40Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-c94c6ddfa34341a6bffb7628e8e4fc242023-11-22T06:33:17ZengMDPI AGAntibiotics2079-63822021-07-0110892110.3390/antibiotics10080921Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative StudyMarkus Rupp0Susanne Baertl1Nike Walter2Florian Hitzenbichler3Martin Ehrenschwender4Volker Alt5Department for Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, GermanyDepartment for Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, GermanyDepartment for Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, GermanyDepartment of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, 93053 Regensburg, GermanyInstitute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, 93053 Regensburg, GermanyDepartment for Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, GermanyThis study aims to investigate (1) microbial patterns in fracture-related infections (FRIs) in comparison to microbiological patterns of periprosthetic joint infections (PJIs), (2) the identification of effective empiric antibiotic therapy for FRIs and PJIs and (3) analysis of difficult-to-treat (DTT) pathogens. Patients treated for FRIs or PJIs from 2017 to 2020 were evaluated for pathogens detected during treatment. Antibiotic susceptibility profiles were examined with respect to broadly used antibiotics and antibiotic combinations. Resistance rates to rifampicin or fluoroquinolone were determined. A total of 81 patients with PJI and 86 with FRI were included in the study. For FRIs <i>Staphylococcus aureus</i> was the most common infection-causing pathogen (37.4% vs. 27.9% for PJI). Overall, there was no statistical difference in pathogen distribution (<i>p</i> = 0.254). For FRIs, combinations of gentamicin + vancomycin (93.2%), co-amoxiclav + glycopeptide and meropenem + vancomycin (91.9% each) would have been effective for empiric therapy, similar to PJIs. Difficult to treat pathogens were more frequently detectable in PJIs (11.6% vs. 2.3%). Empiric therapy combinations such as gentamicin + vancomycin, co-amoxiclav + glycopeptide or meropenem + vancomycin, are effective antibiotic strategies for both FRI and PJI patients. More DTT pathogens were detectable in PJIs compared to FRIs.https://www.mdpi.com/2079-6382/10/8/921empiric antimicrobial therapyfracture-related infectionprosthetic joint infectiondifficult to treat pathogens |
| spellingShingle | Markus Rupp Susanne Baertl Nike Walter Florian Hitzenbichler Martin Ehrenschwender Volker Alt Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative Study Antibiotics empiric antimicrobial therapy fracture-related infection prosthetic joint infection difficult to treat pathogens |
| title | Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative Study |
| title_full | Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative Study |
| title_fullStr | Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative Study |
| title_full_unstemmed | Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative Study |
| title_short | Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative Study |
| title_sort | is there a difference in microbiological epidemiology and effective empiric antimicrobial therapy comparing fracture related infection and periprosthetic joint infection a retrospective comparative study |
| topic | empiric antimicrobial therapy fracture-related infection prosthetic joint infection difficult to treat pathogens |
| url | https://www.mdpi.com/2079-6382/10/8/921 |
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