Causative organisms in revision total hip & knee arthroplasty for infection: Increasing multi-antibiotic resistance in coagulase-negative Staphylococcus and the implications for antibiotic prophylaxis

A M Malhas (Lead / Corresponding author), R Lawton, M Reidy, D Nathwani, B A Clift

    Research output: Contribution to journalArticle

    17 Citations (Scopus)

    Abstract

    BACKGROUND AND PURPOSE: Increasing resistance among post-operative Coagulase-negative Staphylococci (CNS) infections have been reported. We present our experience changing resistance patterns.

    METHODS: We examined microbiological results from hip and knee revisions from 2001 to 2010 and compared resistance to all Staphylococcus aureus (SA) and CNS cultured from regional pan-speciality sources, in order to examine the patterns of antibiotic resistance.

    MAIN FINDINGS: 72 revisions in 67 patients were included. The most common organisms were SA (36%) and CNS (35%). Resistance to methicillin was 72% for CNS versus 20% for SA and resistance to gentamicin was 40% for CNS versus 4% for SA. Among all regional (background pan-speciality) cultures SA resistance to methicillin fell from 32% to 16% from 2006 to 10 with no change in gentamicin resistance at 3%. During the same period resistance of CNS to methicillin and gentamicin increased from 63% to 70% and 32%-47% respectively.

    CONCLUSIONS: Resistance of CNS to both methicillin and gentamicin is higher than with SA and appears to be increasing. At least 32% of CNS and 4% of SA from infected TKRs/THRs were resistant to our current prophylaxis regime. These changing patterns of resistance may have implications for future antibiotic prophylaxis regimes.

    Original languageEnglish
    Pages (from-to)250-5
    Number of pages6
    JournalSurgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
    Volume13
    Issue number5
    Early online date10 May 2014
    DOIs
    Publication statusPublished - Oct 2015

    Keywords

    • Adult
    • Aged
    • Aged, 80 and over
    • Anti-Bacterial Agents
    • Antibiotic Prophylaxis
    • Arthroplasty, Replacement, Hip
    • Arthroplasty, Replacement, Knee
    • Coagulase
    • Drug Resistance, Multiple, Bacterial
    • Female
    • Humans
    • Male
    • Middle Aged
    • Prosthesis-Related Infections
    • Retrospective Studies
    • Staphylococcus aureus
    • Journal Article

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