Gram-negative aetiology in hip and knee prosthetic joint infections: risk factors and implications for empirical antibiotic therapy—a retrospective cohort study
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Le résumé fourni par la source
Abstract Background Empirical broad-spectrum antibiotic therapy is currently recommended for patients undergoing surgical treatment of prosthetic joint infections (PJIs), while awaiting intraoperative culture results. However, widespread use of Gram-negative coverage may lead to more adverse reactions, resistance selections and costs. Objectives This study aimed to identify the factors associated with having a PJI caused by Gram-negative bacteria (GNB). Methods This was an observational retrospective study of patients with hip and knee PJIs undergoing infection surgery between 2015 and 2019. PJI was defined according to 2018 Musculoskeletal Infection Society-International Consensus Meeting criteria. To assess risk factors for GNB-PJI, univariate and multivariate logistic regression analysis was carried out; statistical significance was considered for P values <0.05. Results A total of 281 patients were included, 137/281 (49%) were males, median age was 68 years (IQR 55-75), and the hip was involved in 147/281 (52%) cases. The most frequent surgical approach was a two-stage revision, carried out in 171/281 (61%), and the overall treatment failure rate was 19% (54/281). A Gram-negative aetiology was found in 51/281 (18%) cases; in this group the most frequent aetiological agents were Enterobacterales (n = 36). After surgery, 192/281 (68%) patients received empirical broad-spectrum antibiotic therapy with GNB coverage. In the logistic regression analysis, hip PJI was an independent risk factor for GNB-PJI (OR 2.88, 95% CI 1.44–5.77, P = 0.003) while delayed infection was associated with lower risk (OR 0.45, 95% CI 0.21–0.94, P = 0.03). Conclusions In our cohort, hip PJI was associated with a higher likelihood of GNB infection, whereas delayed-onset PJI was associated with a significantly lower likelihood.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Gram-negative aetiology in hip and knee prosthetic joint infections: risk factors and implications for empirical antibiotic therapy—a retrospective cohort study
- Date Crossref
- 01/09/2026
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Azienda USL di Bologna pays non établi dans la noticeÉtablissement de santé
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University of Bologna Department of Medical and Surgical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Instituto de Salud Carlos III CIBER de Enfermedades Infecciosas pays non établi dans la noticeOrganisation à but non lucratif
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Sociedad Española de Medicina de Familia y Comunitaria pays non établi dans la noticeOrganisation à but non lucratif
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Instituto de Investigación Marqués de Valdecilla pays non établi dans la noticeInstitution
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Spanish Society of Hematology and Hemotherapy pays non établi dans la noticeInstitution
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Centro de Investigación Biomédica en Red Enfermedades Infecciosas pays non établi dans la noticeStructure de recherche
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Guglielmo da Saliceto Hospital Infectious Diseases Unit pays non établi dans la noticeÉtablissement de santé
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University of Ferrara Department of Translational Medicine pays non établi dans la noticeUniversité ou école supérieure
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Istituto Ortopedico Rizzoli pays non établi dans la noticeÉtablissement de santé
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Infectious Diseases Unit pays non établi dans la noticeInstitution
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Hospital Universitario Marqués de Valdecilla-IDIVAL Infectious Diseases Service pays non établi dans la noticeÉtablissement de santé
Azienda USL di Bologna, Department of Medical and Surgical Sciences — University of Bologna et CIBER de Enfermedades Infecciosas — Instituto de Salud Carlos III, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.