Causative organisms in revision total hip & knee arthroplasty for infection: Increasing multi-antibiotic resistance in coagulase-negative Staphylococcus and the implications for antibiotic prophylaxis. Issue 5 (October 2015)

• Record Type: Journal Article
• Authors: Malhas, A.M.; Lawton, R.; Reidy, M.; Nathwani, D.; Clift, B.A.
• Is Part Of: Surgeon. Volume 13:Issue 5(2015)
• Page Start: 250
• Page End: 255
• Publication Date: 2015-10
• Subjects: Surgery -- Periodicals; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617
• DOI: 10.1016/j.surge.2014.04.002
• Languages: English
• ISSNs: 1479-666X

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Background and purpose</title> <p id="abspara0010">Increasing resistance among post-operative Coagulase-negative <italic>Staphylococci</italic> (CNS) infections have been reported. We present our experience changing resistance patterns.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">We examined microbiological results from hip and knee revisions from 2001 to 2010 and compared resistance to all <italic>Staphylococcus aureus</italic> (SA) and CNS cultured from regional pan-speciality sources, in order to examine the patterns of antibiotic resistance.</p> </sec> <sec> <title id="sectitle0025">Main findings</title> <p id="abspara0020">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.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">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.</p> </sec> </abstract>