Prosthetic joint infection(PJI) due to β-hemolytic streptococci (β-HS)

E. F. Berbari, M. C. Duffy, C. N. Morris, J. M. Steckelberg, A. D. Hanssen, D. R. Osmon

Research output: Contribution to journalArticle

Abstract

Objective: To determine the epidemiology and outcome of PJI episodes due to β-HS Methods: All patients with a total hip (THA) or total knee (TKA) arthroplasty infection due to β-HS according to a strict case definition, seen at our institution between 1969 and 1991 were identified and their medical records reviewed. Treatment failure was defined as reoccurrence of GBS PJI according to the original case definition. Results: Thirty one THA and 9 TKA infections due to β-HS in 34 patients were identified. There were 20 males and 20 females with a median age of 69 years (range 44-95). The median time between joint arthroplasty and PJI was 2.4 years (range 0.1-13.1). Of the 40 episodes of β-HS PJI, 22 (55 %) were due to group B Streptococci, 12 (30 %) to group G streptococci, 4 (10%) to group A streptococci and 2 (5%) to group C streptococci. A malignancy was present in 13 (32.5%) of the cases, diabetes mellitus in 6 (15%), and rheumatoid arthritis in 6 (15%). 1/9 (11%) of β-HS PJI treated with two-stage exchange arthroplasty, 0/17 (0%) treated with resection arthroplasy or arthrodesis, 2/11 (18.2%) treated with debridement and retention of the prosthesis and 1/3 (33.4%) treated with antimicrobial therapy alone developed treatment failure after a median follow-up of 4.0 years (range 0.12-12.62). Effective parenteral antimicrobial therapy was administered in 39/40 episodes (penicillin (55%), cefazolin (27.5%), other (17.5%) for a median of 29 days (range: 3-57). Chronic oral antimicrobial suppression was used in 7/11 cases treated with debridment and retention of the components and in 1/3 cases treated with antimicrobial therapy alone. Conclusion: PJI due to β-HS is rare. A variety of different surgical and medical management strategies, including debridment and retention of the prosthesis followed by chronic oral antimicrobial suppression may be useful in treating β-HS PJI.

Original languageEnglish (US)
Pages (from-to)415
Number of pages1
JournalClinical Infectious Diseases
Volume25
Issue number2
StatePublished - 1997

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Streptococcus
Joints
Infection
Prosthesis Retention
Tacrine
Treatment Failure
Arthroplasty
Cefazolin
Knee Replacement Arthroplasties
Streptococcus agalactiae
Arthrodesis
Debridement
Penicillins
Medical Records
Hip
Rheumatoid Arthritis
Diabetes Mellitus
Epidemiology
Therapeutics

ASJC Scopus subject areas

  • Immunology

Cite this

Berbari, E. F., Duffy, M. C., Morris, C. N., Steckelberg, J. M., Hanssen, A. D., & Osmon, D. R. (1997). Prosthetic joint infection(PJI) due to β-hemolytic streptococci (β-HS). Clinical Infectious Diseases, 25(2), 415.

Prosthetic joint infection(PJI) due to β-hemolytic streptococci (β-HS). / Berbari, E. F.; Duffy, M. C.; Morris, C. N.; Steckelberg, J. M.; Hanssen, A. D.; Osmon, D. R.

In: Clinical Infectious Diseases, Vol. 25, No. 2, 1997, p. 415.

Research output: Contribution to journalArticle

Berbari, EF, Duffy, MC, Morris, CN, Steckelberg, JM, Hanssen, AD & Osmon, DR 1997, 'Prosthetic joint infection(PJI) due to β-hemolytic streptococci (β-HS)', Clinical Infectious Diseases, vol. 25, no. 2, pp. 415.
Berbari EF, Duffy MC, Morris CN, Steckelberg JM, Hanssen AD, Osmon DR. Prosthetic joint infection(PJI) due to β-hemolytic streptococci (β-HS). Clinical Infectious Diseases. 1997;25(2):415.
Berbari, E. F. ; Duffy, M. C. ; Morris, C. N. ; Steckelberg, J. M. ; Hanssen, A. D. ; Osmon, D. R. / Prosthetic joint infection(PJI) due to β-hemolytic streptococci (β-HS). In: Clinical Infectious Diseases. 1997 ; Vol. 25, No. 2. pp. 415.
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abstract = "Objective: To determine the epidemiology and outcome of PJI episodes due to β-HS Methods: All patients with a total hip (THA) or total knee (TKA) arthroplasty infection due to β-HS according to a strict case definition, seen at our institution between 1969 and 1991 were identified and their medical records reviewed. Treatment failure was defined as reoccurrence of GBS PJI according to the original case definition. Results: Thirty one THA and 9 TKA infections due to β-HS in 34 patients were identified. There were 20 males and 20 females with a median age of 69 years (range 44-95). The median time between joint arthroplasty and PJI was 2.4 years (range 0.1-13.1). Of the 40 episodes of β-HS PJI, 22 (55 {\%}) were due to group B Streptococci, 12 (30 {\%}) to group G streptococci, 4 (10{\%}) to group A streptococci and 2 (5{\%}) to group C streptococci. A malignancy was present in 13 (32.5{\%}) of the cases, diabetes mellitus in 6 (15{\%}), and rheumatoid arthritis in 6 (15{\%}). 1/9 (11{\%}) of β-HS PJI treated with two-stage exchange arthroplasty, 0/17 (0{\%}) treated with resection arthroplasy or arthrodesis, 2/11 (18.2{\%}) treated with debridement and retention of the prosthesis and 1/3 (33.4{\%}) treated with antimicrobial therapy alone developed treatment failure after a median follow-up of 4.0 years (range 0.12-12.62). Effective parenteral antimicrobial therapy was administered in 39/40 episodes (penicillin (55{\%}), cefazolin (27.5{\%}), other (17.5{\%}) for a median of 29 days (range: 3-57). Chronic oral antimicrobial suppression was used in 7/11 cases treated with debridment and retention of the components and in 1/3 cases treated with antimicrobial therapy alone. Conclusion: PJI due to β-HS is rare. A variety of different surgical and medical management strategies, including debridment and retention of the prosthesis followed by chronic oral antimicrobial suppression may be useful in treating β-HS PJI.",
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T1 - Prosthetic joint infection(PJI) due to β-hemolytic streptococci (β-HS)

AU - Berbari, E. F.

AU - Duffy, M. C.

AU - Morris, C. N.

AU - Steckelberg, J. M.

AU - Hanssen, A. D.

AU - Osmon, D. R.

PY - 1997

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N2 - Objective: To determine the epidemiology and outcome of PJI episodes due to β-HS Methods: All patients with a total hip (THA) or total knee (TKA) arthroplasty infection due to β-HS according to a strict case definition, seen at our institution between 1969 and 1991 were identified and their medical records reviewed. Treatment failure was defined as reoccurrence of GBS PJI according to the original case definition. Results: Thirty one THA and 9 TKA infections due to β-HS in 34 patients were identified. There were 20 males and 20 females with a median age of 69 years (range 44-95). The median time between joint arthroplasty and PJI was 2.4 years (range 0.1-13.1). Of the 40 episodes of β-HS PJI, 22 (55 %) were due to group B Streptococci, 12 (30 %) to group G streptococci, 4 (10%) to group A streptococci and 2 (5%) to group C streptococci. A malignancy was present in 13 (32.5%) of the cases, diabetes mellitus in 6 (15%), and rheumatoid arthritis in 6 (15%). 1/9 (11%) of β-HS PJI treated with two-stage exchange arthroplasty, 0/17 (0%) treated with resection arthroplasy or arthrodesis, 2/11 (18.2%) treated with debridement and retention of the prosthesis and 1/3 (33.4%) treated with antimicrobial therapy alone developed treatment failure after a median follow-up of 4.0 years (range 0.12-12.62). Effective parenteral antimicrobial therapy was administered in 39/40 episodes (penicillin (55%), cefazolin (27.5%), other (17.5%) for a median of 29 days (range: 3-57). Chronic oral antimicrobial suppression was used in 7/11 cases treated with debridment and retention of the components and in 1/3 cases treated with antimicrobial therapy alone. Conclusion: PJI due to β-HS is rare. A variety of different surgical and medical management strategies, including debridment and retention of the prosthesis followed by chronic oral antimicrobial suppression may be useful in treating β-HS PJI.

AB - Objective: To determine the epidemiology and outcome of PJI episodes due to β-HS Methods: All patients with a total hip (THA) or total knee (TKA) arthroplasty infection due to β-HS according to a strict case definition, seen at our institution between 1969 and 1991 were identified and their medical records reviewed. Treatment failure was defined as reoccurrence of GBS PJI according to the original case definition. Results: Thirty one THA and 9 TKA infections due to β-HS in 34 patients were identified. There were 20 males and 20 females with a median age of 69 years (range 44-95). The median time between joint arthroplasty and PJI was 2.4 years (range 0.1-13.1). Of the 40 episodes of β-HS PJI, 22 (55 %) were due to group B Streptococci, 12 (30 %) to group G streptococci, 4 (10%) to group A streptococci and 2 (5%) to group C streptococci. A malignancy was present in 13 (32.5%) of the cases, diabetes mellitus in 6 (15%), and rheumatoid arthritis in 6 (15%). 1/9 (11%) of β-HS PJI treated with two-stage exchange arthroplasty, 0/17 (0%) treated with resection arthroplasy or arthrodesis, 2/11 (18.2%) treated with debridement and retention of the prosthesis and 1/3 (33.4%) treated with antimicrobial therapy alone developed treatment failure after a median follow-up of 4.0 years (range 0.12-12.62). Effective parenteral antimicrobial therapy was administered in 39/40 episodes (penicillin (55%), cefazolin (27.5%), other (17.5%) for a median of 29 days (range: 3-57). Chronic oral antimicrobial suppression was used in 7/11 cases treated with debridment and retention of the components and in 1/3 cases treated with antimicrobial therapy alone. Conclusion: PJI due to β-HS is rare. A variety of different surgical and medical management strategies, including debridment and retention of the prosthesis followed by chronic oral antimicrobial suppression may be useful in treating β-HS PJI.

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