Orthopedic implant-associated infection: the main etiological agents, local resistance and antimicrobial therapy recommendations

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Abstract

Surgical site infections remain a major complication of arthroplasty, spinal stabilization or other orthopedic surgeries. The pathogenesis of these complications is related to use orthopedic implants. This retrospective study investigated the microbiological etiology of implant-associated infection after orthopedic surgery over a 3-year period (2010-2012). The antibiotic resistance profiles of 1350 clinical microbial isolates were determined. The biofilm forming capacity of 394 staphylococcal strains was tested. Statistical analysis was performed using Z-criterion. From a results of the microbiological culture, Staphylococcus aureus and Staphylococcus epidermidis were isolated in 49,9% of cases, followed by: Enterococcus faecalis - 6,4%, Pseudomonas aeruginosa - 5,9%, Acinetobacter spp - 5,1% and members of the family Enterobacteriaceae - 4.1%. MRSA amounted to 23,9% and MRSE - 56,6% (p<0,05) . The percentage of strong biofilm forming strains was more among S.epidermidis strains compared to S. aureus strains (46,4 vs 37,3%; p<0,05). The strains of both Staphylococcus spp, isolated from tissue bioptates and removed orthopedic implants, possessed strong biofilm forming capacity more often than isolates from aspirates (p<0,05). The recommendations for empirical and etiotropic therapy of implant-associated infection after orthopedic surgeries were developed on the basis of data on antibiotic resistance of studied microorganisms.

About the authors

S. A. Bozhkova

Vreden Russian Research Institute for Traumatology and Orthopedics

Author for correspondence.
Email: clinpharm-rniito@yandex.ru
Russian Federation

R. M. Tikhilov

Vreden Russian Research Institute for Traumatology and Orthopedics; Mechnikov North-Western State Medical University

Email: info@rniito.org
Russian Federation

M. V. Krasnova

Vreden Russian Research Institute for Traumatology and Orthopedics

Email: m_kras@list.ru
Russian Federation

A. N. Rukina

Vreden Russian Research Institute for Traumatology and Orthopedics

Email: anrukina@rniito.ru
Russian Federation

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