Short-term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatment

Infectious complications after primary implantation of the hip joint are 0.5–3 %, and in the case of re-endoprosthetics, the risk of periprosthetic infection can reach 30 %. Also, we should not forget about the high percentage (16–20 %) of recurrence of periprosthetic infection of the hip joint, whi...

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Main Authors: E. A. Fedorov, S. O. Kretien, A. G. Samokhin, N. V. Tikunova, A. A. Korytkin, V. V. Pavlov
Format: Article
Language:Russian
Published: Scientific Сentre for Family Health and Human Reproduction Problems 2021-10-01
Series:Acta Biomedica Scientifica
Subjects:
Online Access:https://www.actabiomedica.ru/jour/article/view/2973
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author E. A. Fedorov
S. O. Kretien
A. G. Samokhin
N. V. Tikunova
A. A. Korytkin
V. V. Pavlov
author_facet E. A. Fedorov
S. O. Kretien
A. G. Samokhin
N. V. Tikunova
A. A. Korytkin
V. V. Pavlov
author_sort E. A. Fedorov
collection DOAJ
description Infectious complications after primary implantation of the hip joint are 0.5–3 %, and in the case of re-endoprosthetics, the risk of periprosthetic infection can reach 30 %. Also, we should not forget about the high percentage (16–20 %) of recurrence of periprosthetic infection of the hip joint, which leads to an unsatisfactory result of treatment up to amputation of a limb or even death of the patient. The reasons for the recurrence of the infectious process can be antibiotic resistance and antibiotic tolerance of microorganisms, as well as the ability of microorganisms to form biofilms on implants. In this regard, there is a constant need to search for alternative means of antimicrobial therapy, as well as to select the optimal ways of their delivery and deposition, which is of practical importance when performing surgical interventions in traumatology and orthopedics to protect the implantable structure from possible infection of the surgical site. One of the methods currently available to combat bacterial infections acquired antibiotic resistance and antibiotic tolerance is the use of natural viruses that infect bacterial bacteriophages. The above suggests a more effective suppression of periprosthetic infection, including persisters that deviate from antibiotics. It is, as a rule, associated with biofilms if used in conjunction with antibiotics and phages, when the use of bacteriophages predetermines the effectiveness of treatment. With the use of sensitive bacteriophages in the treatment of periprosthetic infections, a significant (p = 0.030) reduction in the rate of recurrence of infection (from 31 to 4.5 %) was observed. The use of lytic bacteriophages in traumatology and orthopedics is of great interest for phagotherapy of infections caused by antibiotic-resistant and biofilm-forming strains of bacteria. A clinical study using a single-stage surgical revision with simultaneous application of antibiotics and phages in the treatment of deep periprosthesis infection of the hip joint endoprosthesis, followed by 12 months follow-up for periprosthetic infection recurrence, demonstrated the effectiveness of the use of combined antibiotic and bacteriophages treatment.
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spelling doaj.art-d415d973b12b4116a57d59b6ad442f352024-03-28T07:49:24ZrusScientific Сentre for Family Health and Human Reproduction ProblemsActa Biomedica Scientifica2541-94202587-95962021-10-0164506310.29413/ABS.2021-6.4.52184Short-term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatmentE. A. Fedorov0S. O. Kretien1A. G. Samokhin2N. V. Tikunova3A. A. Korytkin4V. V. Pavlov5Novosibirsk Research Institute of Traumatology and OrthopedicsNovosibirsk Research Institute of Traumatology and OrthopedicsNovosibirsk Research Institute of Traumatology and OrthopedicsSiberian Branch of the Russian Academy of SciencesNovosibirsk Research Institute of Traumatology and OrthopedicsNovosibirsk Research Institute of Traumatology and OrthopedicsInfectious complications after primary implantation of the hip joint are 0.5–3 %, and in the case of re-endoprosthetics, the risk of periprosthetic infection can reach 30 %. Also, we should not forget about the high percentage (16–20 %) of recurrence of periprosthetic infection of the hip joint, which leads to an unsatisfactory result of treatment up to amputation of a limb or even death of the patient. The reasons for the recurrence of the infectious process can be antibiotic resistance and antibiotic tolerance of microorganisms, as well as the ability of microorganisms to form biofilms on implants. In this regard, there is a constant need to search for alternative means of antimicrobial therapy, as well as to select the optimal ways of their delivery and deposition, which is of practical importance when performing surgical interventions in traumatology and orthopedics to protect the implantable structure from possible infection of the surgical site. One of the methods currently available to combat bacterial infections acquired antibiotic resistance and antibiotic tolerance is the use of natural viruses that infect bacterial bacteriophages. The above suggests a more effective suppression of periprosthetic infection, including persisters that deviate from antibiotics. It is, as a rule, associated with biofilms if used in conjunction with antibiotics and phages, when the use of bacteriophages predetermines the effectiveness of treatment. With the use of sensitive bacteriophages in the treatment of periprosthetic infections, a significant (p = 0.030) reduction in the rate of recurrence of infection (from 31 to 4.5 %) was observed. The use of lytic bacteriophages in traumatology and orthopedics is of great interest for phagotherapy of infections caused by antibiotic-resistant and biofilm-forming strains of bacteria. A clinical study using a single-stage surgical revision with simultaneous application of antibiotics and phages in the treatment of deep periprosthesis infection of the hip joint endoprosthesis, followed by 12 months follow-up for periprosthetic infection recurrence, demonstrated the effectiveness of the use of combined antibiotic and bacteriophages treatment.https://www.actabiomedica.ru/jour/article/view/2973staphylococcusbacteriophageperiprosthetic infectionendoprosthesiship joint
spellingShingle E. A. Fedorov
S. O. Kretien
A. G. Samokhin
N. V. Tikunova
A. A. Korytkin
V. V. Pavlov
Short-term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatment
Acta Biomedica Scientifica
staphylococcus
bacteriophage
periprosthetic infection
endoprosthesis
hip joint
title Short-term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatment
title_full Short-term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatment
title_fullStr Short-term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatment
title_full_unstemmed Short-term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatment
title_short Short-term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatment
title_sort short term results of treatment of staphylococcal periprosthetic hip joint infection with combined antibiotics and bacteriophages treatment
topic staphylococcus
bacteriophage
periprosthetic infection
endoprosthesis
hip joint
url https://www.actabiomedica.ru/jour/article/view/2973
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