Causative pathogens at hip and knee prosthetic joint infections, treatment regimens and evaluation of prognosis

Aim: Prosthetic joints increasingly used in recent years raises the prosthetic joint infections. Prosthetic joint infection significantly increase the hospital length of stay and treatment cost. This study aimed at identifying the source of infection, microorganisms, risk factors, treatment strategies and prognose for the patient diagnosed with hip prosthetic joint infection diagnosed and followed at our hospital and thereby contributing to future patient management.Materials and Method: The files of patients applied to our Clinical Bacteriology and Infectious Diseases and Orthopedy clinic and policlinics, diagnosed with knee and hip prosthetic joint infection and treated and followed were respectively examined. The following data were retrospectively analysed; patients demographic data, risk factors, the data on the hospital where the prosthesis was implemented, the number of infection episodes, initial diagnoses time of infection, symptoms and findings, laboratory data, the data of operations, isolated microorganisms and the applied treatment protocols and prognosis data. SPSS v.11.5 was used.Findings: The mean age of the 88 patients 31 of whom were male (%35,2) and who are diagnosed with prosthetic joint infections was 58,8±15,9. The most frequent reason of prosthesis insertion for the patients was traumatic (n = 36) (40.9%) and the most frequent symptom was pain 80 (%90,9). The relation between the existence of a previous surgery at the same joint and result was found to be statistically significant (p=0,008). The most frequent isolated microorganisms in both discharge and perioperative cultures were koagülase negatif stafilococcus. The pathogen could not be isolated in 17 (%19,3) of the patients. The mean level of CRP and ESR were high. In the patients underwent two-stage revision, the good result rate was higher (%75,9) and statistically significant (p=0,016). The good result rate in the spacer used patient during the two-stage revision was %76,8 which was not statistically significant(p=0,631).The total treatment time for prosthetic joint infections in the patient with good results was longer.Results: The pathogen isolation in prosthetic joint infections is important since it determines the surgery method and antimicrobial treatment. In our study, we found that a longitudinal antimicrobial treatment combined with surgery in prosthetic joint infections and the selection of surgery appropriate for the patient and pathogen and antimicrobial treatment have affected the prognose.Key words: Antibiotic treatment, CRP and ESR levels, debridman and retansition, foreign body, glikocalics layer infections , Prosthetic joint infections, revision procedures.