Clinical Features of Group B Streptococcus Prosthetic Joint Infections and Molecular Characterization of Isolates

Abstract Background Enterobacter prosthetic joint infections (PJIs) are rare, occurring mainly in elderly people usually with complex medical and surgical history, and their treatment is usually challenging. Aim of this study is to assess the characteristics and outcomes of Enterobacter PJIs. Methods A retrospective multi-centric cohort was studied at three hospitals from January 2012 to December 2018. Patients with PJIs were identified using ICD codes. Enterobacter PJIs were then identified through reviewing patients’ electronic medical records. Results 13 enterobacter PJIs were identified. 9 (69%) were polymicrobial. Mean age of the patients was 61.7 years, and mean BMI was 34.6 kg/m2. 8 patients (62%) were females, and 8 patients (62%) were Caucasians. Infected sites were: Hip in 5 patients (38%%), knee in 5 patients (38%) and ankle in 3 patients (23%) patients. 9 patients (69%) had osteoarthritis, 3 patients (23%) had diabetes mellitus, and 1 patient (8%) had connective tissue diseases requiring steroids. Most patients (11 out of 13) (85%) presented within 1 week of symptoms onset. Presenting clinical features were pain in 9 patients (69%), drainage in 10 patients (77%), purulence in 7 patients (54%), and fever in 5 patients (38%). 11 patients (85%) were managed with debridement, antibiotics and implant retention (DAIR), and 2 patients (15%) with antibiotics alone. Antibiotics used while managing were as follows: Cefepime n = 6, quinolones n = 2, carbapenems n = 4 and aminoglycosides n = 1. Outcome: 4 patients (31%) developed deep surgical site infections (and two of them required implant removal), 5 patients had no events in 12 months of follow-up, 3 patients (23%) had less than 6 months of follow-up, and one patient died in the hospital due to cardiac failure. Conclusion In our study, most cases of Enterobacter PJIs were polymicrobial. The success rate in monomicrobial infections was 75% while overall it was noted to be 38%. DAIR was associated with high readmission rates and deep surgical site infections (36%). 18% cases managed with DAIR required implant removal. Disclosures All authors: No reported disclosures.

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Molecular characterization of pathogenic group B streptococcus from a tertiary hospital in Shanxi, China: High incidence of sequence type 10 strains in infants/pregnant women

Journal of Microbiology Immunology and Infection ◽

10.1016/j.jmii.2020.07.018 ◽

2020 ◽

Author(s):

Li Zhang ◽

Lan Ma ◽

Lei Zhu ◽

Xiang-Hong Zhou ◽

Li-Jun Xu ◽

...

Keyword(s):

Pregnant Women ◽

Molecular Characterization ◽

Group B Streptococcus ◽

Tertiary Hospital ◽

Sequence Type ◽

High Incidence ◽

Group B

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Characterization of Outcomes of 2-Stage Exchange Arthroplasty in the Treatment of Prosthetic Joint Infections

The Journal of Arthroplasty ◽

10.1016/j.arth.2018.02.043 ◽

2018 ◽

Vol 33 (7) ◽

pp. S224-S227 ◽

Cited By ~ 12

Author(s):

Amy N. Ford ◽

Adam M. Holzmeister ◽

Harold W. Rees ◽

Paul D. Belich

Keyword(s):

Joint Infections ◽

Exchange Arthroplasty ◽

Prosthetic Joint ◽

Prosthetic Joint Infections

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Clinical features and outcome of Streptococcus agalactiae bone and joint infections over a 6-year period in a French university hospital

PLoS ONE ◽

10.1371/journal.pone.0248231 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248231

Author(s):

Paul Loubet ◽

Yatrika Koumar ◽

Catherine Lechiche ◽

Nicolas Cellier ◽

Sophie Schuldiner ◽

...

Keyword(s):

Diabetes Mellitus ◽

Clinical Features ◽

Streptococcus Agalactiae ◽

Treatment Success ◽

University Hospital ◽

Joint Infections ◽

Bone And Joint Infections ◽

Prosthetic Joint ◽

Device Infection ◽

Prosthetic Joint Infections

Background Bone and joint infections (BJIs) due to Streptococcus agalactiae are rare but has been described to increase in the past few years. The objective of this study was to describe clinical features and outcomes of cases of S. BJIs. Methods We conducted a retrospective analysis of adult cases of S. agalactiae BJIs that occurred between January 2009 and June 2015 in a French university hospital. The treatment success was assessed until 24 months after the end of antibiotic treatment. Results Among the 26 patients included, 20 (77%) were male, mean age was 62 years ± 13 and mean Charlson comorbidity index score was 4.9 ± 3.2. Diabetes mellitus was the most common comorbidity (n = 14, 54%). Six had PJI (Prosthetic Joint Infections), five osteosynthesis-associated infections, 11 osteomyelitis and four native septic arthritis. Eleven patients had a delayed or late infection: six with a prosthetic joint infection and five with an internal fixation device infection. Sixteen patients (62%) had a polymicrobial BJI, most commonly with Gram-positive cocci (75%) notably Staphylococcus aureus (44%). Polymicrobial infections were more frequently found in foot infections (90% vs 44%, p = 0.0184). During the two-year follow-up, three patients died (3/25, 12%) and seven (7/25, 28%) had treatment failure. Conclusion Diabetes mellitus was the most common comorbidity. We observed an heterogenous management and a high rate of relapse.

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