Johns Hopkins ABX Guide
Prosthetic Joint Infections
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
- Cutibacterium acnes (especially shoulder implant infections, formerly Propionibacterium)
- 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 the time of onset following prosthesis placement:
- Early infection (0-3 months post-op): predominantly S. aureus, β-hemolytic streptococci, Gram-negative bacilli, polymicrobial infection, anaerobic
- Delayed (3 mos-2 yrs): usual pathogens include coagulase-negative Staphylococci,S. aureus,C. acnes, Enterococcus spp.
- Late (>2 yrs): S. aureus, coagulase-negative Staphylococci, viridans Streptococci, Enterococci, C. acnes
- Less common: Gram-negatives
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Last updated: August 8, 2022
Citation
Auwaerter, Paul G, and Sara Keller. "Prosthetic Joint Infections." Johns Hopkins ABX Guide, The Johns Hopkins University, 2022. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections.
Auwaerter PG, Keller S. Prosthetic Joint Infections. Johns Hopkins ABX Guide. The Johns Hopkins University; 2022. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections. Accessed December 2, 2023.
Auwaerter, P. G., & Keller, S. (2022). Prosthetic Joint Infections. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections
Auwaerter PG, Keller S. Prosthetic Joint Infections [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2022. [cited 2023 December 02]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections.
* Article titles in AMA citation format should be in sentence-case
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T1 - Prosthetic Joint Infections
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UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540256/all/Prosthetic_Joint_Infections
PB - The Johns Hopkins University
DB - Johns Hopkins Guides
DP - Unbound Medicine
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