Prosthetic Joint Infections
Prosthetic Joint Infections is a topic covered in the Johns Hopkins ABX Guide.
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PATHOGENS
- Staphylococci account for >50% of total prosthetic joint infections (PJI). Gram negatives may account for 15%. Approximately 20% may be polymicrobial.
- Culture negative infections represent ~7-11% of infections; some may be due to prior abx therapy.
- Bacterial:
- Staphylococcus (coagulase-negative)
- Staphylococcus aureus
- Viridans streptococci
- Propionibacterium acnes (especially shoulder implant infections)
- Enterococcal species
- Gram-negative enteric bacteria
- Pseudomonas aeruginosa
- Anaerobes
- Brucella spp: rare
- Mycobacterial:
- Non-tubercular mycobacteria: rare
- M. tuberculosis: very rare
- Fungal:
- Candida species
- Typical pathogens by time of onset following prosthesis placement:
- Early infection (0-3 months post-op): predominantly S. aureus, β-hemolytic strep, Gram-negative bacilli
- Delayed (3 mos-2 yrs): usual pathogens include coagulase-negative Staphylococci,S. aureus , P. acnes
- Late (>2 yrs): S. aureus, coagulase-negative Staphylococci, viridans Streptococci, Enterococci, P. acnes
- Less common: Gram-negatives
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