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

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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.

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S. Bozhkova

Vreden Russian Research Institute for Traumatology and Orthopedics

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Email: clinpharm-rniito@yandex.ru
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R. Tikhilov

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

Email: info@rniito.org
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M. Krasnova

Vreden Russian Research Institute for Traumatology and Orthopedics

Email: m_kras@list.ru
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A. Rukina

Vreden Russian Research Institute for Traumatology and Orthopedics

Email: anrukina@rniito.ru
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