Different microbial and resistance patterns in primary total knee arthroplasty infections - a report on 283 patients from Lithuania and Sweden

dc.contributor.authorSebastian, Sujeesh
dc.contributor.authorSezgin, Erdem Aras
dc.contributor.authorStucinskas, Justinas
dc.contributor.authorTarasevicius, Sarunas
dc.contributor.authorLiu, Yang
dc.contributor.authorRaina, Deepak Bhushan
dc.contributor.authorTagil, Magnus
dc.contributor.authorLidgren, Lars
dc.contributor.authorW-Dahl, Annette
dc.date.accessioned2021-12-13T06:08:48Z
dc.date.available2021-12-13T06:08:48Z
dc.date.issued2021
dc.departmentTıp Fakültesi
dc.description.abstractBackground The microbiology and the susceptibility patterns of infected total knee arthroplasties (TKAs) vary depending on demographic, local antimicrobial stewardship, and surgical factors. We wanted to compare the recent microbial profile and antimicrobial resistance pattern in revisions due to infections after primary TKAs in Sweden and Lithuania. Our hypothesis was that there is a difference in bacteriology and resistance pattern based on patient related, societal and local hospital factors as almost similar praxis have been applied for TKA surgery, short term systemic prophylaxis and routine use of local gentamicin containing bone cement. Methods Primary TKAs revised for the first time due to verified or suspected infection were collected nationwide in Sweden during 2018, and in Lithuania between 2011 and 2020 from a single major TKA revision centre in Kaunas. We identified 202 TKAs in Sweden from the Swedish Knee Arthroplasty Register and 84 from Kaunas revised due to infection. We collected available culture reports and evaluated the type of microorganisms with antimicrobial resistance pattern at revision. Results The majority of the infected cases in Sweden were early-type prosthetic joint infection (PJI) (44%), whereas late-type PJI (52%) were more common in the Kaunas cases. Gram-positive bacteria prevailed in both Sweden (55%) and Lithuania (80%). Staphylococcus aureus was the most frequent organism identified in both countries (33% in Sweden and 34% in Lithuania). More polymicrobial infections were observed in Sweden than in Lithuania (16 and 6% respectively). Methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci were higher in Lithuania (4/28 and 19/29) than in Sweden (1/42 and 9/41). Conclusions The type of infections, microbial profile, and drug resistance pattern differed between Sweden and Lithuania. Societal and local hospitals factors with emerging resistance in Lithuania are the most plausible explanation for the difference. Lack of complete data on a national level in Lithuania underlines the importance of adding microbiology of PJIs in implant registers for national aggregation and allow cross country comparisons.
dc.identifier.doi10.1186/s12891-021-04689-5
dc.identifier.endpage-en_US
dc.identifier.issn1471-2474
dc.identifier.issue1en_US
dc.identifier.pmid34535109
dc.identifier.scopusqualityQ2
dc.identifier.startpage-en_US
dc.identifier.urihttps:/dx.doi.org/10.1186/s12891-021-04689-5
dc.identifier.urihttps://hdl.handle.net/20.500.12451/8930
dc.identifier.volume22en_US
dc.identifier.wosWOS:000696825900001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBMC Musculoskeletal Disorders
dc.relation.ispartofBMC Musculoskeletal Disorders
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectDrug Resistance
dc.subjectKnee Arthroplasty Register
dc.subjectMicrobial Profile
dc.subjectProsthetic Joint Infection
dc.subjectPolymicrobial Infections
dc.titleDifferent microbial and resistance patterns in primary total knee arthroplasty infections - a report on 283 patients from Lithuania and Sweden
dc.typeArticle

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