Clinical characteristics and risk factors for culture-negative periprosthetic joint infections

Abstract Background Culture-negative periprosthetic joint infections (PJIs) can complicate diagnosis and management of PJI. This study aimed to identify risk factors for culture-negative PJI and differences in clinical characteristics between culture-positive and culture-negative PJI group. Methods This retrospective, cross-sectional study evaluated PJI cases obtained between January 2013 and October 2019 at our institution. These PJI cases were divided into culture-positive and culture-negative groups and then compared. The demographics, laboratory findings, and details of patient’s clinical characteristics were investigated. Univariate and multivariate logistic regression analysis were performed to investigate risk factors for culture-negative PJI. Results A total of 109 PJI cases were included in the analysis: 82 (75%) culture-positive and 27 (25%) culture-negative. The mean serum white blood cell (WBC) count, C-reactive protein level, and erythrocyte sedimentation rate in the culture-negative group were significantly lower than those in the culture-positive group (p < 0.05). There were no significant differences between the two groups regarding history of prior antibacterial administration or treatment success rates. Multivariate analysis identified a low serum WBC count as a risk factor for culture-negative PJI (odds ratio = 0.78; 95% confidence interval [CI] = 0.63–0.97; p = 0.027). Conclusions A low serum WBC count is a risk factor for culture-negative PJI, but prior antimicrobial therapy is not. The results suggest that PJI cases with lower levels of systemic inflammation are likely to be culture-negative; therefore, the possibility of a culture-negative result should be considered in suspected cases of PJI with low inflammatory markers, regardless of prior antibiotic exposure.

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Clinical Characteristics and Risk Factors for Culture-Negative Periprosthetic Joint Infections

10.21203/rs.3.rs-67752/v3 ◽

2021 ◽

Author(s):

Shintaro Watanabe ◽

Naomi Kobayashi ◽

Akito Tomoyama ◽

Hyonmin Choe ◽

Etsuko Yamazaki ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Clinical Characteristics ◽

Treatment Success ◽

Multivariate Logistic Regression Analysis ◽

Joint Infections ◽

Wbc Count ◽

Culture Positive ◽

Culture Negative ◽

Low Serum

Abstract Background Culture-negative periprosthetic joint infections (PJIs) can complicate diagnosis and management of PJI. This study aimed to identify risk factors for culture-negative PJI and differences in clinical characteristics between culture-positive and culture-negative PJI group. Methods This retrospective, cross-sectional study evaluated PJI cases obtained between January 2013 and October 2019 at our institution. These PJI cases were divided into culture-positive and culture-negative groups and then compared. The demographics, laboratory findings, and details of patient’s clinical characteristics were investigated. Univariate and multivariate logistic regression analysis were performed to investigate risk factors for culture-negative PJI. Results A total of 109 PJI cases were included in the analysis: 82 (75%) culture-positive and 27 (25%) culture-negative. The mean serum white blood cell (WBC) count, C-reactive protein level, erythrocyte sedimentation rate in the culture-negative group were significantly lower than those in the culture-positive group (p < 0.05). There were no significant differences between the two groups regarding history of prior antibacterial administration or treatment success rates. Multivariate analysis identified a low serum WBC count as a risk factor for culture-negative PJI (odds ratio = 0.78; 95% confidence interval [CI] = 0.63–0.97; p = 0.027). Conclusions A low serum WBC count is a risk factor for culture-negative PJI, but prior antimicrobial therapy is not. The results suggest that PJI cases with lower levels of systemic inflammation are likely to be culture-negative; therefore, the possibility of a culture-negative result should be considered in suspected cases of PJI with low inflammatory markers, regardless of prior antibiotic exposure.

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Clinical Characteristics and Risk Factors for Culture-Negative Periprosthetic Joint Infections

10.21203/rs.3.rs-67752/v1 ◽

2020 ◽

Author(s):

Shintaro Watanabe ◽

Naomi Kobayashi ◽

Akito Tomoyama ◽

Hyonmin Choe ◽

Etsuko Yamazaki ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Clinical Characteristics ◽

Treatment Success ◽

Multivariate Logistic Regression Analysis ◽

Joint Infections ◽

Wbc Count ◽

Culture Positive ◽

Culture Negative ◽

Low Serum

Abstract Background: Culture-negative periprosthetic joint infections (PJIs) can complicate diagnosis and management of PJI. This study aimed to identify risk factors for culture-negative PJI and differences in clinical characteristics between culture-positive and culture-negative PJI group. Methods: This retrospective, cross-sectional study evaluated PJI cases obtained between January 2013 and October 2019 at our institution. These PJI cases were divided into culture-positive and culture-negative groups and then compared. The demographics, laboratory findings, and details of patient’s clinical characteristics were investigated. Univariate and multivariate logistic regression analysis were performed to investigate risk factors for culture-negative PJI.Results: A total of 109 PJI cases were included in the analysis: 82 (75%) culture-positive and 27 (25%) culture-negative. The mean serum white blood cell (WBC) count, C-reactive protein level, erythrocyte sedimentation rate in the culture-negative group were significantly lower than those in the culture-positive group (p < 0.05). There were no significant differences between the two groups regarding history of prior antibacterial administration or treatment success rates. Multivariate analysis identified a low serum WBC count as a risk factor for culture-negative PJI (odds ratio = 0.78; 95% confidence interval [CI] = 0.63–0.97; p = 0.027).Conclusions: A low serum WBC count is a risk factor for culture-negative PJI, but prior antimicrobial therapy is not. The results suggest that PJI cases with lower levels of systemic inflammation are likely to be culture-negative; therefore, the possibility of a culture-negative result should be considered in suspected cases of PJI with low inflammatory markers, regardless of prior antibiotic exposure.

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Clinical Characteristics and Risk Factors for Culture-Negative Periprosthetic Joint Infections

10.21203/rs.3.rs-67752/v2 ◽

2020 ◽

Author(s):

Shintaro Watanabe ◽

Naomi Kobayashi ◽

Akito Tomoyama ◽

Hyonmin Choe ◽

Etsuko Yamazaki ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Clinical Characteristics ◽

Treatment Success ◽

Multivariate Logistic Regression Analysis ◽

Lower Serum ◽

Joint Infections ◽

Wbc Count ◽

Culture Positive ◽

Culture Negative

Abstract Background: Culture-negative periprosthetic joint infections (PJIs) can complicate diagnosis and management of PJI. This study aimed to identify risk factors for culture-negative PJI and differences in clinical characteristics between culture-positive and culture-negative PJI group. Methods: This retrospective, cross-sectional study evaluated PJI cases obtained between January 2013 and October 2019 at our institution. These PJI cases were divided into culture-positive and culture-negative groups and then compared. The demographics, laboratory findings, and details of patient’s clinical characteristics were investigated. Univariate and multivariate logistic regression analysis were performed to investigate risk factors for culture-negative PJI.Results: A total of 109 PJI cases were included in the analysis: 82 (75%) culture-positive and 27 (25%) culture-negative. The mean serum white blood cell (WBC) count, C-reactive protein level, erythrocyte sedimentation rate in the culture-negative group were significantly lower than those in the culture-positive group (p < 0.05). There were no significant differences between the two groups regarding history of prior antibacterial administration or treatment success rates. Multivariate analysis identified a lower serum WBC count as a risk factor for culture-negative PJI (odds ratio = 0.78; 95% confidence interval [CI] = 0.63–0.97; p = 0.027).Conclusions: A lower serum WBC count is a risk factor for culture-negative PJI, but prior antimicrobial therapy is not. The results suggest that PJI cases with lower levels of systemic inflammation are likely to be culture-negative; therefore, the possibility of a culture-negative result should be considered in suspected cases of PJI with low inflammatory markers, regardless of prior antibiotic exposure.

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Risk Factors and Outcome of Contamination in Patients on Peritoneal Dialysis—A Single-Center Experience of 15 Years

Peritoneal Dialysis International ◽

10.3747/pdi.2011.00268 ◽

2012 ◽

Vol 32 (6) ◽

pp. 612-616 ◽

Cited By ~ 8

Author(s):

Desmond Y.H. Yap ◽

Wai Ling Chu ◽

Flora Ng ◽

Terence Pok Siu Yip ◽

Sing Leung Lui ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Peritoneal Dialysis ◽

Clinical Outcomes ◽

Clinical Characteristics ◽

Prophylactic Antibiotics ◽

Catheter Removal ◽

Single Center ◽

Single Center Experience ◽

Culture Negative

♦ ObjectiveContamination is an important risk factor for peritoneal dialysis (PD)–related peritonitis. The present study outlines the clinical characteristics and outcomes of PD patients experiencing touch contamination.♦ MethodsWe reviewed the case records of PD patients from 1995 to 2010. Patients who experienced contamination of their PD system were identified and stratified into “dry” and “wet” contamination groups. Risk factors, microbiology, and clinical outcomes were compared.♦ ResultsOf 548 episodes of touch contamination, 246 involved dry contamination, and 302, wet contamination. After contamination, 17 episodes of peritonitis (3.1%) developed; all episodes occurred in the wet contamination group ( p < 0.001). The incidence of peritonitis after wet contamination was 5.63%. Prophylactic antibiotics significantly reduced the risk of peritonitis (1 of 182 episodes, p < 0.001). Half the patients experiencing peritonitis had either culture-negative or staphylococcal episodes, and most of those episodes responded to intraperitoneal antibiotics. In 2 patients, peritonitis was attributable to Pseudomonas, and in 3, to Acinetobacter. In these latter patients, outcomes were less favorable, with catheter removal being required in 4 of the 5 episodes.♦ ConclusionsThe overall rate of peritonitis was low after contamination. Wet contamination was associated with a much higher risk of peritonitis. Prophylactic antibiotics after wet contamination were effective in preventing peritonitis.

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Shoulder Joint Infections with Negative Culture Results: Clinical Characteristics and Treatment Outcomes

BioMed Research International ◽

10.1155/2019/3756939 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Mohamed Attia Abdou ◽

Ahreum Jo ◽

Ik-Sun Choi ◽

Chae-Jin Iim ◽

Hyeng-Kyu Park ◽

...

Keyword(s):

Treatment Outcomes ◽

Shoulder Joint ◽

Clinical Characteristics ◽

Demographic Data ◽

Multiple Logistic Regression Analysis ◽

Negative Results ◽

Joint Infections ◽

Functional Scores ◽

Culture Positive ◽

Culture Negative

Background. The incidence of septic arthritis of the shoulder joint is increasing as the population ages. The prevalence of shoulder infection is also increasing because of the growing use of arthroscopy and expansion of procedures in the shoulder. However, cultures do not always identify all microorganisms, even in symptomatic patients. The incidence of negative cultures ranges from 0% to 25%. Few studies have reported clinical features and treatment outcomes of culture-negative shoulder infections. This cohort study addresses culture-negative shoulder joint infections in nonarthroplasty patients. This study aimed to compare clinical characteristics and treatment outcomes of patients with culture-negative results to those with culture-positive results. Our hypothesis was that culture-negative infections would have more favorable outcomes than culture-positive infections. Methods. We retrospectively reviewed data of 36 patients (17 culture-negative and 19 culture-positive) with shoulder infections between June 2004 and March 2015. The minimum follow-up duration was 1.2 years (mean, 5 ± 3.8 years; range, 1.2-11 years). We assessed preoperative demographic data and characteristics, laboratory markers, imaging and functional scores, intraoperative findings, and postoperative findings of both groups. Results. Culture-negative patients (17/36, 47.2%) had a significantly lower occurrence of repeated surgical debridement (culture-negative vs. culture-positive: 1.2 ± 0.4 vs. 2.4 ± 1.7, p = 0.002) without osteomyelitis. In the multiple logistic regression analysis, the presence of osteomyelitis [odds ratio (OR) = 9.7, 95% confidence interval (CI): 1.0-91.8, p=0.04)] and the number of surgical debridements (OR = 5.3, 95% CI: 1.3-21.6, p=0.02) were significantly associated with culture-positive infections. Conclusions. Culture-negative infections without osteomyelitis are less severe than culture-positive infections. Culture-negative infections can be controlled more easily and are not necessarily a negative prognostic factor for shoulder joint infections.

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Culture-negative versus culture-positive in pyogenic spondylitis and analysis of risk factors for relapse

British Journal of Neurosurgery ◽

10.1080/02688697.2021.1896677 ◽

2021 ◽

pp. 1-5

Author(s):

Guohua Dai ◽

Shuzhong Li ◽

Chuqiang Yin ◽

Yuanliang Sun ◽

Jianwen Hou ◽

...

Keyword(s):

Risk Factors ◽

Pyogenic Spondylitis ◽

Culture Positive ◽

Culture Negative

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Risk Factors for Aortic Valve Calcification in Patients on Regular Hemodialysis

The International Journal of Artificial Organs ◽

10.1177/039139880903200308 ◽

2009 ◽

Vol 32 (3) ◽

pp. 173-179 ◽

Cited By ~ 4

Author(s):

Dejan Petrović ◽

Radmila Obrenović ◽

Biljana Stojimirović

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Risk Factor ◽

Aortic Valve ◽

Independent Risk Factor ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Aortic Valve Calcification ◽

Valve Calcification ◽

Regular Hemodialysis

Introduction Aortic valve calcification (AVC) accelerates development of aortic valve stenosis and cardiovascular complications. Hyperphosphatemia is one of the key risk factors for aortic valve calcification. Aim The aim of this study was to evaluate the prevalence of AVC in patients on regular hemodialysis and to assess the impact of different factors on its appearance. Method: The study investigated a total of 115 patients treated in the Hemodialysis Department of the Urology and Nephrology Clinic at the Kragujevac Clinical Center in Serbia. The variables investigated were: serum albumin, C-reactive protein (CRP), homocysteine, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), Apolipoprotein A-I (Apo A-I), Apolipoprotein B (Apo B) and lipoprotein (a), calcium, phosphate and parathormone, and calcium-phosphorus product (Ca × P). Patients were evaluated by echocardiography for AVC. Statistical analysis included univariate and multivariate logistic regression analysis. Results Univariate regression analysis showed that serum phosphate levels and Ca × P are the most important risk factors for AVC (p<0.001). Multivariate logistic regression analysis revealed that hyperphosphatemia is an independent risk factor for AVC (p<0.001). Conclusion Hyperphosphatemia is an independent risk factor for aortic valve calcification.

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Administration of Antithrombotic Treatment Was a Risk Factor for Intraperitoneal Hemorrhage in Patients Undergoing Percutaneous Interventions for Liver Diseases.

10.21203/rs.3.rs-150259/v1 ◽

2021 ◽

Author(s):

Akira Asai ◽

Keisuke Yokohama ◽

Hideko Ohama ◽

Yusuke Tsuchimoto ◽

Shinya Fukunishi ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Liver Diseases ◽

Retrospective Cohort ◽

Clinical Characteristics ◽

Ultrasound Guided ◽

Antithrombotic Treatment ◽

Percutaneous Interventions ◽

Intraperitoneal Hemorrhage ◽

Number Of Patients

Abstract Percutaneous interventions for liver diseases are currently essential for diagnosis and treatment. The most frequent complication of percutaneous interventions is intraperitoneal hemorrhage. Recently, the number of patients with liver diseases and administered antithrombotics has been increasing. This retrospective cohort study aimed to evaluate the risk factors for intraperitoneal hemorrhage after percutaneous interventions for liver diseases. This study recruited 1025 patients who underwent percutaneous interventions for liver diseases from April 2015 to March 2020. All interventions were performed using an ultrasound-guided approach. Intraperitoneal hemorrhage after percutaneous interventions was detected by abdominal computed tomography. Intraperitoneal hemorrhage occurred in 9 patients (0.88%), and these adverse events weren’t severe. We compared clinical characteristics between the patients with intraperitoneal hemorrhage and without. There were differences regarding patients who underwent percutaneous treatments of liver tumor (p = 0.1271), administration of antithrombotics (p = 0.1961), and prothrombin time (p = 0.1683). Thereafter, to evaluate the influence of antithrombotics on hemorrhage, we compared the patients with antithrombotics and without. After propensity score matching, hemorrhage in patients treated with antithrombotics was significantly increased than in those without (p = 0.0407). The administration of antithrombotics was a risk factor for intraperitoneal hemorrhage in patients undergoing percutaneous interventions for liver diseases.

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684. Risk Stacking for Pneumococcal Disease in Costa Rica

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.691 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S247-S247

Author(s):

Jorge Chaverri-Murillo ◽

Manuel Ramírez-Cardoce ◽

José Castro-Cordero

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Costa Rica ◽

High Risk ◽

Pneumococcal Disease ◽

Heart Diseases ◽

High Risk Factor ◽

Tertiary Hospitals ◽

Risk Patients ◽

Culture Positive

Abstract Background The value of nontraditional high-risk factor stacking is not known in the Costa Rican population. We aim to describe risk factor stacking for pneumococcal disease (PD) in patients seeking care at Social Security Hospitals in Costa Rica Methods Descriptive study of adult patients with microbiological culture-positive Streptococcus pneumoniae disease seeking care at two tertiary hospitals in Costa Rica between years 2014 and 2016. Information on underlying comorbidities (nontraditional) and other risk factors for PD was analyzed and stalked for each age group (G1: <50, G2: 50–64, and G3: ≥65 y/o). Results We included 181 culture-positive patients. We found that patients in G1 predominantly stacked ≥2 risk factors (63%), the proportion of patients with ≥2 risk factor was similar to high-risk patients in G2 (33% vs. 38%). In G3, 18% didn’t stacked any other risk factor and 46% was on high-risk. Most frequent risk factors in G1/G2 were smoking and alcoholism, and in G3 chronic pulmonary and heart diseases. Conclusion We conclude that risk factor stacking is more relevant than high-risk conditions and PD also occurs in persons <50 y/o. We recommend that risk factor stacking should be considered in prevention strategies for PD. Disclosures All authors: No reported disclosures.

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The clinical characteristics and outcome of cryptococcal meningitis with AIDS in a tertiary hospital in China: an observational cohort study

BMC Infectious Diseases ◽

10.1186/s12879-020-05661-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Liang Wu ◽

Jiang Xiao ◽

Yangzi Song ◽

Guiju Gao ◽

Hongxin Zhao

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Clinical Characteristics ◽

Multivariate Logistic Regression Analysis ◽

Tertiary Hospital ◽

Multivariate Logistic Regression ◽

Duration Of Treatment ◽

Aids Patients ◽

Disease Prognosis ◽

Consciousness Disorder

Abstract Background Despite the profound impact of antiretroviral therapy in the control of AIDS mortality, central nervous system opportunistic infections remains a significant burden in AIDS patients. This retrospective study aims to elucidate the clinical characteristics, outcome and risk factors of cryptococcal meningitis (CM) poor prognosis in AIDS patients from a tertiary hospital in China. Methods Clinical data from 128 patients admitted in Beijing Ditan Hospital, Capital Medical University from November 2008 to November 2017 was collected. The cohort was stratified based on treatment outcome (effective 79%, and ineffective 21%), and Multivariate Logistic regression analysis used to identify risk factors of poor disease prognosis. Results Age, incidence of cerebral infarction, the proportion of consciousness disorder, and fasting plasma glucose was higher in the ineffective treatment group than the effective treatment group. The duration of treatment in the induction period of the ineffective group was significantly shorter than that of the effective group. Multivariate Logistic regression analysis indicated that the occurrence of cerebral hernia and consciousness disorder were risk factors for the prognosis of AIDS patients with CM infection, while the duration of treatment in the induction period was a indicative of a better prognosis in AIDS with CM infection complications. Finally, shunt decompression therapy correlated with a better disease outcome. Conclusions This retrospective study exposes the main risk factors associated with worse disease prognosis in AIDS patients with CM infection complications.

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