scholarly journals Risk factors for periprosthetic joint infection after primary artificial hip and knee joint replacements

2020 ◽  
Vol 14 (06) ◽  
pp. 565-571
Author(s):  
Heng Guo ◽  
Chi Xu ◽  
Jiying Chen
Keyword(s):  
Risk Factors ◽  
Knee Joint ◽  
Joint Replacement ◽  
Joint Infection ◽  
History Of Surgery ◽  
Surgical Time ◽  
Superficial Infection ◽  
Hip Joint Replacement ◽  
Joint Replacements ◽  
History Of

Introduction: We aimed to explore the risk factors for periprosthetic joint infection (PJI) after primary artificial hip and knee joint replacements by performing a case-control study. Methodology: The clinical data of patients receiving primary hip and knee joint replacements were retrospectively analyzed. The case group included 96 patients who suffered from PJI, comprising 42 cases of hip joint replacement and 54 cases of knee joint replacement. Another 192 patients who received joint replacement at the ratio of 1:2 in the same period and did not suffer from PJI were selected as the control group. Differences between the two groups were compared in regard to etiology, pathogen, blood type, urine culture, body mass index (BMI), surgical time, intraoperative blood loss, postoperative 1st day and total drainage volumes, length of hospitalization stay, and history of surgery at the affected sites. Results: Gram-positive bacteria were the main pathogens for PJI. The most common infection after hip joint replacement was caused by Staphylococcus epidermidis, which accounted for 38.10%, while Staphylococcus aureus was mainly responsible for the infection of knee joint (40.74%). High BMI, long surgical time, large postoperative drainage volume, long hospitalization stay, history of surgery at incisions, previous use of immunosuppressants, preoperative hypoproteinemia and superficial infection were independent risk factors (p < 0.05). Conclusions: PJI after primary replacement was mainly caused by gram-positive bacteria, and patients with high BMI, long surgical time, large postoperative drainage volume, long hospitalization stay, history of surgery at incisions, previous use of immunosuppressants, preoperative hypoproteinemia and superficial infection were more vulnerable.

scholarly journals Clinical and microbiological characteristics of periprosthetic hip and knee infections

2020 ◽  
pp. 237-240
Author(s):  
Vladimir A. ​ Ivantsov ◽  
I.P. Bogdanovich ◽  
V.V. Lashkovskiy ◽  
V.S. Anosov
Keyword(s):  
Surgical Treatment ◽  
Knee Joint ◽  
Hip Joint ◽  
Joint Replacement ◽  
Periprosthetic Infection ◽  
Joint Infection ◽  
Knee Joints ◽  
Knee Joint Replacement ◽  
Hip Joint Replacement ◽  
Total Knee

Objective. To characterize periprosthetic joint infection in patients undergoing a total hip and knee joint replacement. Materials and Methods. A total of 77 patients with periprosthetic infection following hip and knee joint replacement hospitalized in Grodno City Clinical Hospital were studied over the period of 2014-2018. Wound discharge, tissue samples, and fistula’s wall swab were used for microbiological tests. The analysis of surgical treatment of patients with deep periprosthetic knee and hip joint infection has been performed. Results. Periprosthetic infection after hip joint arthroplasty was observed in 32 (41.6%) patients, and after total knee joint arthroplasty in 45 (58.4%) patients. Surgical treatment was performed in 18 (56.3%) and 32 (71.1%) patients with periprosthetic infection following total knee and hip joint replacement, respectively. A total of 10 (31.2%) of 32 cultures from patients with periprosthetic infection after total hip joint replacement and 8 (17.8%) of 45 cultures from patients with periprosthetic infection after total knee joint replacement were positive. Overall, Staphylococcus aureus was detected in 9 (50%) of 18 positive cultures. Gram-negative aerobic bacteria (Acinetobacter baumannii, Klebsiella pneumoniae Pseudomonas aeruginosa) were detected in 4⁄10 and 5⁄8 of positive cultures from patients with periprosthetic infection of hip and knee joints, respectively. Conclusions. The most common pathogens causing periprosthetic infection of hip and knee joints were S. aureus (50%) and Gram-negative bacteria. The surgical treatment was performed in 71.4% of patients with periprosthetic joint infection.

scholarly journals Periprosthetic Joint Infections as a Consequence of Bacteremia

2019 ◽  
Vol 6 (6) ◽  
Author(s):  
Meeri Honkanen ◽  
Esa Jämsen ◽  
Matti Karppelin ◽  
Reetta Huttunen ◽  
Antti Eskelinen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Joint Replacement ◽  
Joint Infection ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hip Joint Replacement ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Staphylococcus Aureus Bacteremia

Abstract Background The risk for developing a periprosthetic joint infection (PJI) during bacteremia is unclear, except for Staphylococcus aureus bacteremia. The aim of this study was to examine the risk for developing a PJI during bacteremia and to identify possible risk factors leading to it. Methods Patients with a primary knee or hip joint replacement performed in a tertiary care hospital between September 2002 and December 2013 were identified (n = 14 378) and followed up until December 2014. Positive blood culture results during the study period and PJIs were recorded. PJIs associated with an episode of bacteremia were identified and confirmed from patient records. Potential risk factors for PJI among those with bacteremia were examined using univariate logistic regression. Results A total of 542 (3.8%) patients had at least 1 episode of bacteremia. Seven percent (47/643) of the bacteremias resulted in a PJI. Development of a PJI was most common for Staphylococcus aureus (21% of bacteremias led to a PJI) and beta-hemolytic streptococci (21%), whereas it was rare for gram-negative bacteria (1.3%). Having ≥2 bacteremias during the study period increased the risk for developing a PJI (odds ratio, 2.29; 95% confidence interval, 1.17–4.50). The risk for developing a PJI was highest for bacteremias occurring within a year of previous surgery. Chronic comorbidities did not affect the risk for PJI during bacteremia. Conclusions The development of a PJI during bacteremia depends on the pathogen causing the bacteremia and the timing of bacteremia with respect to previous joint replacement surgery. However, significant patient-related risk factors for PJI during bacteremia could not be found.

scholarly journals POS1143 GOUT AND JOINT REPLACEMENTS IN THE US

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 851.1-851
Author(s):  
G. Singh ◽  
M. Sehgal ◽  
A. Mithal
Keyword(s):  
Knee Joint ◽  
Confidence Intervals ◽  
Knee Replacement ◽  
Joint Replacement ◽  
Economic Burden ◽  
Hip Replacement ◽  
Average Charge ◽  
Joint Replacements ◽  
Increased Risk ◽  
The Us

Background:Irreversible joint damage in gout has been linked to a possible increase in knee and hip joint replacements1. In addition, the strong association between gout and osteoarthritis2,3 could also lead to an increased risk of joint replacements in patients with gout. Population-based data from the UK and Taiwan have shown hazard rates of 1.14 and 1.16 respectively for knee replacements in patients with gout compared to age and gender matched controls1. However, there is little national data in the US on clinical and economic burden of joint replacements in patients with gout.Objectives:To evaluate total or partial hip and knee joint replacements in patients with gout in the US and to estimate their economic impactMethods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. Detailed information including clinical and nonclinical data elements on each hospital stay including International Classification of Diseases (ICD)10 diagnosis and procedure codes, age, gender, length of stay, payer, charges, comorbidities etc. is available. We examined hospitalizations in patients with gout with hip and knee joint replacements in NIS 2018, the most recent year of data.Results:In 2018, there were 914,510 hospitalizations with primary or secondary diagnosis of gout in the US. Of these 43,615 were for joint replacement surgeries (knee (24,840) and hip (18,755)). Patients with knee replacement were on an average 68.5 years old (95% confidence intervals 68.2 years -68.8 years). Patients with hip replacement were slightly older (mean age 70.3 years, 95% confidence intervals 69.8 years -70.7 years). Unlike general population statistics, men formed a majority of these joint replacements (68% for the knee and 72% for the hip). The average charge per hospitalization was $69,279 and $72,944 for knee and hip replacement respectively. The total annual national cost estimate was $3.09 billion, with government insurances (Medicare and Medicaid) responsible for 67% of knee replacement and 70% of hip replacement costs.Conclusion:Joint replacements in gout patients have a large clinical and economic burden in the US. This calls for an increased awareness and management of associated hip and knee arthritis in patients with gout.References:[1]Kuo CF, Chou IJ, See LC, et al. Urate-lowering treatment and risk of total joint replacement in patients with gout. Rheumatology. Dec 1 2018;57(12):2129-2139.[2]Howard RG, Samuels J, Gyftopoulos S, et al. Presence of gout is associated with increased prevalence and severity of knee osteoarthritis among older men: results of a pilot study. Journal of clinical rheumatology: practical reports on rheumatic & musculoskeletal diseases. Mar 2015;21(2):63-71.[3]Roddy E, Zhang W, Doherty M. Are joints affected by gout also affected by osteoarthritis? Annals of the rheumatic diseases. Oct 2007;66(10):1374-1377.Disclosure of Interests:Gurkirpal Singh Shareholder of: Pfizer, Merck, Sanofi, Grant/research support from: Horizon, Maanek Sehgal: None declared, Alka Mithal: None declared.

scholarly journals Extended follow-up of patients suspected of having joint sepsis after total joint replacement

1985 ◽  
Vol 95 (3) ◽  
pp. 655-664 ◽  
Author(s):  
O. M. Lidwell ◽  
E. J. L. Lowbury ◽  
W. Whyte ◽  
R. Blowers ◽  
D. Lowe
Keyword(s):  
Knee Joint ◽  
Failure Rate ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Joint Infection ◽  
Hospital Records ◽  
Knee Joint Replacement ◽  
Total Hip

SUMMARYDuring an average follow-up time of about 2½ years after total hip or knee-joint replacement in 8052 patients, suspected joint infection was recorded in 85 patients whose joints had not been re-operated during that period. The hospital records of 72 of these patients were examined after a further period, averaging about 5 years. Thirty-five of these had suffered continuing major problems with the joint, 18 of which had been revised, and a further 9 joints needed such treatment. Infection was confirmed in 17 of the 35. These numbers are proportionately about three times greater than those observed among a set of matched controls followed-up for a similar period. The evidence from the extended follow-up suggests that the failure rate, unassociated with infection, reached about 5% by 7 years after operation and that late infections, manifested between about 2½ and 7 years after operation, were about as frequent as those confirmed during the first 2½ years.

scholarly journals Seroprevalence and Associated Risk Factors of Hepatitis B Virus Infection Among Children in Enugu Metropolis

2018 ◽  
Vol 9 ◽  
pp. 1178122X1879285 ◽  
Author(s):  
Maryann Chinenye Ezeilo ◽  
Godwill Azeh Engwa ◽  
Romanus Ifeanyi Iroha ◽  
Damian Chukwu Odimegwu
Keyword(s):  
Risk Factors ◽  
Hepatitis B Virus ◽  
Blood Transfusion ◽  
Hepatitis B ◽  
Clinical Manifestations ◽  
Hbv Infection ◽  
Age Group ◽  
History Of Surgery ◽  
B Virus ◽  
History Of

Background: Though measures are being put in place for the management of Hepatitis B virus (HBV) infection in Nigeria, children remain the most vulnerable to develop chronic hepatitis. Routine screening in children is therefore necessary for effective control. However, the performance of the commonly used immunochromatographic test (ICT) strips has been challenging. Also, identifying the risk factors of transmission in this age group is of importance for the implementation of preventive measures. Hence, the goal of this study was to assess the test performance of the routinely used ICT strip and identify the associated clinical manifestations and risk factors of HBV. Methods: A cross sectional study involving 270 children below six years of age was conducted at ESUTH and Favor Child Pediatrics Hospital in Enugu, Nigeria. The subjects were screened for HBV by ICT and ELISA assays and a structured questionnaire was used to obtain participants data including demographic, socioeconomic, signs and symptoms, risk factors and vaccination. Results: BBased on ELISA, 31 out of 270 children were positive for HBV with an infection rate of 11.5%. ICT kit showed a low sensitivity of 51.6% in diagnosing HBV but was highly specific (100%) and accurate (94.4%). HBV infection was not associated with sex (χ2: 0.209; p = 0.401). The prevalence of HBV infection was similar in all the age group and HBV infection was not associated (χ2: 2.099; p = 0.914) with age group. All the clinical manifestations were not associated ( p > 0.05) with HBV infection. Blood transfusion, shared items, tattoo marks and history of surgery associated significantly ( p < 0.05) with HBV infections having odd ratios of 4.247, 4.224, 3.134 and 3.195 respectively. The vaccination rate was 55.2% (159/270) and only 3 (1.1%) out of 159 vaccinated subjected contracted the infection (OR: 0.068, p < 0.0001). Conclusions: HBV was prevalent (11.5%) in children below six years old in Enugu metropolis. Moreover, the routinely used ICT test was less reliable than ELISA in diagnosis HBV infection. More so, shared items, blood transfusion, tattooing and history of surgery were potential risk factors while vaccination served as a protective factor against the infection.

Prevalence of Hepatitis ‘B’ and ‘C’ in Orthopaedics Patients Admitted In Khyber Pakhtunkhwa Hospitals

2021 ◽  
Vol 15 (5) ◽  
pp. 1208-1210
Author(s):  
A. Khan ◽  
M. S. Zardad ◽  
Abdussaboor awan ◽  
M. Tahir ◽  
M. A. E. Bhattani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Blood Transfusion ◽  
Hepatitis B ◽  
Venous Blood ◽  
Previous History ◽  
Prior History ◽  
History Of Surgery ◽  
History Of ◽  
Orthopedic Patients

Background and Aim: Hepatitis B and C are widespread global health issues that are rapidly spreading in developing countries due to ineffective preventive measures.Undiagnosed hepatitis B (HBV) and hepatitis C (HCV) viral infections in hospitalized patients and outdoor attendees must be addressed in order to obtain a more accurate picture of HBV and HCV prevalence.The purpose of this study was to determine the prevalence of HBV and HCV in patients admitted to the orthopedic department. Materials and Methods: This is a descriptive cross-sectional study of 1080 patients admitted to the department of orthopedics at Ayub Medical Teaching Institute Abbottabad and Orthopaedics department of DHQ Hospital Thimergara Dir lower for duration of six months fromSeptember 2019 to February 2020.The study included patients of both sex and all ages who were undergoing surgery. Venous blood was drawn from 1080 people and tested for infection using ELISA.All patients were screened for Hepatitis B and C, and positive patients were confirmed using the Elisa method. Results:Out of 1080 patients, 756 (70%) were male and 324 (30%) were female. Hepatitis B and C were found in 86 (8%) of the patients. Out of 86 infected patients, 49 (4.53 %t) had hepatitis C and 37 (3.42 %) had hepatitis B. The prevalence of both hepatitis B and C infections were 4 (0.37 %) of the patients. Of the 49 hepatitis C patients, 32 (65.3%) were male and 17 (34.7%) were female. Thirty-one (83.8 %) of the 37 hepatitis B patients were male, while six (16.21 %) were female.The prevalence of risk factors were history of blood transfusion 14 (16.27 %) patients, Previous history of surgery 17 (19.8 %), dental procedure 6 (7.00 %), and abroad visit in 5 (5.81 %) patients. Conclusion:Hepatitis B and C are common in orthopedic patients, with the following risk factors: prior history of surgery or blood transfusion. To prevent the transmission of HBV and HCV to others, a routinely screened procedure should be followed on a regular basis. Keywords:Prevalence, Hepatitis B, Hepatitis C, Orthopedic patients.

Predictors and Risk Factors of Severity of GBS, the Requirement for Mechanical Ventilation and Poor Short-Term Prognosis of Severe GBS

2020 ◽  
Author(s):  
Pu-Yuan Wen ◽  
Min Zhang ◽  
Wen-Zheng Chu ◽  
Qiao-Chan Feng ◽  
Han Ji ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Autonomic Dysfunction ◽  
Cranial Nerve ◽  
Recent History ◽  
History Of Surgery ◽  
Logistic Analysis ◽  
Severity Scores ◽  
Short Run ◽  
History Of

Abstract Background/Objective:It is still an extraordiarily exigent thing to early recognize the severity, therapeutic method and prognisis of Guillain-Barré syndrome (GBS). Our research’s goal is to investigate the clinical predictive factors indicating severity of GBS and the requirement for mechanical ventilation(MV) in severe patients with GBS, and to explore the identification of modifiable risk factors for predicting poor short-run outcome of severe GBS. Methods: A total of 155 patients were included in a cohort of GBS patients admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University between 2014 and 2020. Demographic, clinical, therapeutical and evolutionary data were collected. Neurological testing which used standardized data collection were carried out by the same investigators on the whole study period. Comparion of the results were implemented by single and multiple regression analysis.Result: Of 155 patients, 66 patients were severe GBS, of which twenty-nine patients (18.7%) needed MV. Significant clinical predictors for severe GBS were recent history of surgery, time from onset to admission, Medical Research Council(MRC) sum score on admission, autonomic dysfunction, cranial nerve impairment(glossopharyngeal, facial, Oculomotor and/or abducent nerve deficits) and elevated liver enzyme levels were significantly bound up with severity scores(p<0.05). With regard to risk factors of MV in severe GBS, univariate logistic analysis indicated presence of cranial nerve involvement, autonomic dysfunction, MRC score at nadir, elevated liver enzymes and pneumonia were significantly different(p<0.05); Multivariate analysis determined that MRC score at nadir and autonomic dysfunction were also considered to be predictors for MV in severe GBS(p<0.05).As to prognostic of factors, recent history of surgery, MRC score at nadir, the requirement for MV, MRC score at admission and pneumonia during hospitalization were predictors of poor short-run outcome in severe patients with GBS by univariate logistic analysis, and that the nadir MRC score and the requirement for MV were identically proved as clinic parameters of unfavourable prognosis by multivariate logistic analysis (p<0.05) .Conclusions: Clinical risk factors of severity in GBS, the requirement of MV and unfavourable short-run prognosis in severe GBS were evident. Recent history of surgery is also a predictor for severity in GBS patients.

scholarly journals HEPATITIS 'B' AND 'C'

2011 ◽  
Vol 18 (01) ◽  
pp. 69-74
Author(s):  
MUHAMMAD ZAFAR IQBAL ◽  
MUHAMMAD AZEEM ◽  
MUHAMMAD RAZZAQ MALIK
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Blood Transfusion ◽  
Hepatitis B ◽  
Previous History ◽  
Medical College Hospital ◽  
History Of Surgery ◽  
College Hospital ◽  
Medical College ◽  
History Of

Background: Hepatitis B and C is a global problem. The prevalence of hepatitis B and C in orthopedic patients is quite high with the common risk factors: previous history of surgery or blood transfusion. Objectives: The objectives of this study were to, "Find out the prevalence of Hepatitis B and C and their risk factors in patients admitted in Orthopedic Unit of Sheikh Zayed Medical College Hospital Rahim Yar Khan.”. Design & Duration: This was a prospective cohort study. The duration was from July 2009 to December 2009. Patients and Methods: This study was conducted in Orthopedic Department of Sheikh Zayed Medical College Hospital Rahim Yar Khan. Patients of either sex and of all ages who were undergoing orthopedic surgery were included in the study. All patients underwent screening for Hepatitis-B and Hepatitis-C and confirmed by Elisa method in positive patients. Data regarding age, sex, HBV, HCV was noted and analyzed by SPSS version 14. Results: Among 745 patients. 581 (77.98%) were male and 164 (22.02%) were female. Hepatitis B and C was present in 165 (22.15) patients. Out of these positive cases 125 (75.76%) were suffering from hepatitis C and 36 (21.81%) were suffering from hepatitis B, and 4 (2.43%) patients were positive for both HBV & HCV. Among the predisposing factors previous history of surgery was positive in 39 patients; history of blood transfusion in 27 patients, dental procedure was in 17 patients’ and 123 patients having injection therapy in the past. Conclusions: All the patients who need surgery should be properly screened for HBV and HCV. It is also necessary that separate operation theaters and instruments should be used for HBV and HCV positive cases.

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