A four-year prospective study on microbial ecology of explanted prosthetic hips in 52 patients with "aseptic" prosthetic joint loosening

Eur J Clin Microbiol Infect Dis. 1996 Feb;15(2):160-5. doi: 10.1007/BF01591491.

Abstract

The bacteriology of explanted prosthetic hips and surrounding soft tissue was studied in 52 patients undergoing surgical revision for joint loosening. In a prospective four-year study, positive bacterial cultures were recorded in 34 (76%) patients. Coagulase-negative staphylococci were the predominant isolates, and 11 patients (33%) had more than three organisms isolated, 7 (20%) had two only, and 11 (33%) had one species. Among the 23 patients from whom specimens from all 11 predetermined anatomic sites were cultured, the highest frequency of positive cultures (52% and 47%) came from the shaft and capsular tissue, respectively. Organisms were less frequently recovered from the cement and acetabulum (13% and 4%, respectively). Using molecular typing in eight patients with paired isolates of the same species, clonal identity was found in four. An additional patient underwent a second revision for loosening 17 months after the first revision and the same clone of Staphylococcus epidermidis was isolated on both occasions.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colony Count, Microbial
  • Corynebacterium / growth & development
  • Corynebacterium / isolation & purification
  • Electrophoresis, Gel, Pulsed-Field
  • Escherichia coli / growth & development
  • Escherichia coli / isolation & purification
  • Female
  • Gram-Positive Bacteria / growth & development
  • Gram-Positive Bacteria / isolation & purification*
  • Hip Prosthesis / microbiology*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Prosthesis Failure
  • Reoperation
  • Staphylococcus / growth & development
  • Staphylococcus / isolation & purification