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A Review of the Literature on Culture­Negative Periprosthetic Joint Infection: Epidemiology, Diagnosis and Treatment

조성희|이동영|김동희|이상혁|문동규|강병훈|황선철|남대철|윤홍권
대한슬관절학회 (Korean Knee Society)|2017.09|Knee Surgery and Related Research|제29권 제3호|pp. 155-164

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CultureInfectionReviewArthroplasty

초록

Purpose: The prevalence of periprosthetic joint infection (PJI) has increased with the increasing incidence of arthroplasty surgery. Considering identification of causative microorganisms is crucial for treatment of PJI, culture­negative (CN) PJI is a significant clinical issue. The purpose of the present study is to describe epidemiology, diagnosis and treatment of CN PJI based on review of the literature to help prevent delayed diagnosis and improve clinical outcomes of CN PJI. Methods: MEDLINE, EMBASE, Cochrane Library and Scopus databases were searched for articles on CN PJI. Only clinical studies written in English were included. Basic science studies, letters to the editor, case reports and review articles on PJI were excluded. Results: Seven studies were included in this study. The prevalence of CN PJI ranged from 0% to 42.1%. The major risk factors for CN PJI were prior antibiotic use and presence of postoperative wound drainage. Vancomycin and cephalosporins were the most commonly used antibiotics for CN PJI. Two­stage revision arthroplasty followed by 6 weeks of antibiotic therapy produced the most successful treatment outcomes. Conclusions: In most clinical studies on CN PJI, a definite diagnostic method for identifying causative microorganisms or optimal treatment strategy for CN PJI were not clearly described. Therefore, further studies are needed to establish standard diagnostic methods for identifying infecting organisms and treatment strategies for CN PJI.

Abstract

Purpose: The prevalence of periprosthetic joint infection (PJI) has increased with the increasing incidence of arthroplasty surgery. Considering identification of causative microorganisms is crucial for treatment of PJI, culture­negative (CN) PJI is a significant clinical issue. The purpose of the present study is to describe epidemiology, diagnosis and treatment of CN PJI based on review of the literature to help prevent delayed diagnosis and improve clinical outcomes of CN PJI. Methods: MEDLINE, EMBASE, Cochrane Library and Scopus databases were searched for articles on CN PJI. Only clinical studies written in English were included. Basic science studies, letters to the editor, case reports and review articles on PJI were excluded. Results: Seven studies were included in this study. The prevalence of CN PJI ranged from 0% to 42.1%. The major risk factors for CN PJI were prior antibiotic use and presence of postoperative wound drainage. Vancomycin and cephalosporins were the most commonly used antibiotics for CN PJI. Two­stage revision arthroplasty followed by 6 weeks of antibiotic therapy produced the most successful treatment outcomes. Conclusions: In most clinical studies on CN PJI, a definite diagnostic method for identifying causative microorganisms or optimal treatment strategy for CN PJI were not clearly described. Therefore, further studies are needed to establish standard diagnostic methods for identifying infecting organisms and treatment strategies for CN PJI.

참고문헌 (40)

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관련 논문AI추천

Clinical outcomes of two-stage revision for chronic periprosthetic joint infection of the knee: culture-negative versus culture-positive박대현, 이창락, Kim Chang-Wan, Kim Doo-Yeol, Kim Jeong-Woo대한슬관절학회 · Knee Surgery and Related Research2021 · 제33권 Current Guideline for Diagnosis of Periprosthetic Joint Infection: A Review ArticleSeung-Ju Kim, Yun Jae Cho대한고관절학회 · Hip and Pelvis2021 · 제33권 제1호Management of Periprosthetic Joint InfectionAndrej Trampuz, Cheng Li, Nora Renz대한고관절학회 · Hip and Pelvis2018 · 제30권 제3호Periprosthetic Knee Infection: Ten Strategies That WorkClaudio Diaz-Ledezma, Javad Parvizi, Priscilla Ku Cavanaugh대한슬관절학회 · Knee Surgery and Related Research2013 · 제25권 제4호Management of Periprosthetic Hip Joint Infection손원용, 이희동, Kumar Prashant대한고관절학회 · Hip and Pelvis2015 · 제27권 제2호Risk factors of uncontrolled periprosthetic knee joint infection after two-stage reimplantation배기철, Choi Byung-Chan, Kim Dong-Wan, Kim Du-Han대한슬관절학회 · Knee Surgery and Related Research2020 · 제32권

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