Lack of association of Staphylococcus aureus type A β-lactamase with cefazolin combined with antimicrobial spacer placement prosthetic joint infection treatment failure

Jennifer A. Shuford, Kerryl E. Piper, Melanie Hein, Andrej Trampuz, James M. Steckelberg, Robin Patel

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Association of cefazolin treatment failure with type A β-lactamase- producing Staphylococcus aureus has been suggested. The prevalence of β-lactamase gene types among 23 methicillin-susceptible S. aureus (MSSA) isolates associated with prosthetic joint infection (PJI) treated with cefazolin was determined using polymerase chain reaction (PCR), and clinical and microbiologic outcomes were assessed. PCR revealed 4 isolates without blaZ, and 12 with type A, 2 with type B, and 5 with type C blaZ. Of 13 patients undergoing resection arthroplasty with subsequent reimplantation, all received antimicrobial spacer placement at resection with or without antimicrobial- impregnated polymethylmethacrylate at reimplantation. All 13 cases had tissue cultures at time of reimplantation that were negative for S. aureus and 11 had histopathology specimens showing no acute inflammation. Of 8 type A cases undergoing reimplantation, all prostheses remained in place at follow-up (median, 798 days; range, 32-927 days). We conclude that type A blaZ is common in MSSA PJI and that cefazolin therapy for blaZ MSSA PJI can be successful when combined with 2-stage reimplantation and local antimicrobial therapy.

Original languageEnglish (US)
Pages (from-to)189-192
Number of pages4
JournalDiagnostic Microbiology and Infectious Disease
Volume54
Issue number3
DOIs
StatePublished - Mar 1 2006

Keywords

  • Cefazolin
  • Prosthetic joint infection
  • Staphylococcus aureus
  • blaZ
  • β-Lactamase

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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