J Bone Jt Infect 2019; 4(6):285-291. doi:10.7150/jbji.35683

Research Paper

A population-based study on the treatment and outcome of enterococcal prosthetic joint infections. A consecutive series of 55 cases

Olof Thompson1✉, Magnus Rasmussen1, Anna Stefánsdóttir2, Bertil Christensson1, Per Åkesson1

1. Lund University, Department of Clinical Sciences Lund, Division of Infection Medicine and Skåne University Hospital, Department of Infectious Diseases, Lund, Sweden;
2. Lund University, Department of Clinical Sciences Lund, Division of Orthopedics and Skåne University Hospital, Department of Orthopedics, Lund, Sweden.

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Citation:
Thompson O, Rasmussen M, Stefánsdóttir A, Christensson B, Åkesson P. A population-based study on the treatment and outcome of enterococcal prosthetic joint infections. A consecutive series of 55 cases. J Bone Jt Infect 2019; 4(6):285-291. doi:10.7150/jbji.35683. Available from http://www.jbji.net/v04p0285.htm

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Abstract

AIM: Enterococci cause 2-11% of all prosthetic joint infections (PJI) and are generally considered difficult to treat. However, study-results are not consistent. In this study we present a population-based case series of 55 cases with enterococcal PJI, investigating treatment and outcome, as well as describing the affected patient population regarding demography and co-morbidities.

METHODS: We identified all enterococcal PJIs in the Region of Skåne, Sweden, during a five-year period (2011-2015) and reviewed the patients' medical records.

RESULTS: Fifty-five enterococcal PJIs were found. Enterococcus faecalis was the most frequently isolated species (84%), and poly-microbial infections were common (64%). Treatment with intention to cure was given to 43 (78%) cases. Debridement with retention of the implant and antibiotics (DAIR) was the most common surgical treatment strategy (71%), with a cure-rate of 72%. Overall cure-rate was 67%, and in cases where cure was intended, this was achieved in 80%.

CONCLUSIONS: When cure is aimed for, the prognosis for enterococcal PJI is not so poor, and DAIR treatment can provide adequate results in many cases.

Keywords: prosthetic joint infection, Enterococcus faecalis, Enterococcus faecium, debridement, outcome, treatment