Clinical Characteristics of Methicillin-resistant Staphylococcus aureus Infection for Chronic Periprosthetic Hip and Knee Infection
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Purpose: Deep infection after hip and knee arthroplasty is a serious complication and is difficult to treat due toits toxicity. The aims of our study were to find out the differences of methicillin-resistant Staphylococcus aureus(MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) infection after hip and knee arthroplastyfocusing on clinical course and laboratory findings. Materials and Methods: We retrospectively reviewed 61 staphylococcal infection cases after hip and kneearthroplasty (MSSA in 25 patients, MRSA in 36 patients). Vital signs, laboratory tests, microbiology and clinicalcourses were analyzed. The average follow-up period was 3.8 years (range, 2 to 10.1 years). Results: At initial visit, MRSA group showed significant higher erythrocyte sedimentation rate, C-reactive protein(CRP) and neutrophil percentage. The average duration for the normalization of CRP was longer in MRSA group(MRSA: 36.7±25.1 days, MSSA: 24.7±13.6 days; P=0.008). The mean interval between staging operation waslonger in MRSA group (MRSA: mean 8.7 weeks [range, 6.4 to 21.4 weeks], MSSA: mean 6.8 weeks [range, 6 to13.1 weeks]; P=0.012). MRSA group (13.9%) revealed higher recurrence rate than MSSA group (4%). Two patients(5.6%) from MRSA group expired by sepsis. One limb amputation (2.7%) was carried out in MRSA group. Conclusion: MRSA infection after arthroplasty showed more toxic serologic parameter and poorer prognosis. Aggressive treatment should be considered for MRSA infection following arthroplasty.
Abstract
Purpose: Deep infection after hip and knee arthroplasty is a serious complication and is difficult to treat due toits toxicity. The aims of our study were to find out the differences of methicillin-resistant Staphylococcus aureus(MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) infection after hip and knee arthroplastyfocusing on clinical course and laboratory findings. Materials and Methods: We retrospectively reviewed 61 staphylococcal infection cases after hip and kneearthroplasty (MSSA in 25 patients, MRSA in 36 patients). Vital signs, laboratory tests, microbiology and clinicalcourses were analyzed. The average follow-up period was 3.8 years (range, 2 to 10.1 years). Results: At initial visit, MRSA group showed significant higher erythrocyte sedimentation rate, C-reactive protein(CRP) and neutrophil percentage. The average duration for the normalization of CRP was longer in MRSA group(MRSA: 36.7±25.1 days, MSSA: 24.7±13.6 days; P=0.008). The mean interval between staging operation waslonger in MRSA group (MRSA: mean 8.7 weeks [range, 6.4 to 21.4 weeks], MSSA: mean 6.8 weeks [range, 6 to13.1 weeks]; P=0.012). MRSA group (13.9%) revealed higher recurrence rate than MSSA group (4%). Two patients(5.6%) from MRSA group expired by sepsis. One limb amputation (2.7%) was carried out in MRSA group. Conclusion: MRSA infection after arthroplasty showed more toxic serologic parameter and poorer prognosis. Aggressive treatment should be considered for MRSA infection following arthroplasty.
참고문헌 (37)
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