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Bacterial Burden, Not Local Immune Response, Differs Between Acute and Chronic Peri-Prosthetic Joint Infections.
Doub, James B; De Palma, Brian J; Nandi, Sumon.
Afiliación
  • Doub JB; Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • De Palma BJ; Department of Orthopedic Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Nandi S; Department of Orthopedic Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Surg Infect (Larchmt) ; 24(6): 549-553, 2023 Aug.
Article en En | MEDLINE | ID: mdl-37262179
Background: Conducting gram stains in peri-prosthetic joint infections (PJI) is known to have poor sensitivity. However, the aims of this study were to use gram stain results of acute and chronic PJI to determine differences with respect to bacterial burden and levels of local innate immunologic response. Patients and Methods: Patients with acute and chronic PJI from January 1, 2016 and December 31, 2020 were identified by use of Current Procedural Terminology codes. Manual review of medical records for infecting organisms and gram stain results for stained bacteria and for local tissue inflammation (amount of polymorphonuclear leukocytes seen on high powered microscopic fields) were recorded. Statistical comparisons between acute (n = 70) and chronic (n = 134) PJI were analyzed with respect to gram stain sensitivity and amount of local tissue inflammation. Results: The ability to identify stained bacteria was statistically significantly higher in the acute cohort (61.4%) than the chronic cohort (9.7%; p < 0.0001). Interestingly, the amount of local inflammation was similar for acute and chronic PJI except in the subgroup analysis with chronic polymicrobial (p = 0.0229) and chronic culture negative (p = 0.0001) PJI. Conclusions: This study shows that both acute and chronic PJI had similar levels of local inflammation seen on gram stains, despite higher bacterial burdens in acute infections. This suggests that innate immune responses, and thus likelihood of infection eradication, is not solely dependent on bacterial burden. These findings should spearhead further research evaluating the different immunologic responses that occur in acute and chronic PJI to improve diagnostics, therapeutics, and infection-free implant survival.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Infecciosa / Infecciones Relacionadas con Prótesis Tipo de estudio: Guideline / Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Surg Infect (Larchmt) Asunto de la revista: BACTERIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Infecciosa / Infecciones Relacionadas con Prótesis Tipo de estudio: Guideline / Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Surg Infect (Larchmt) Asunto de la revista: BACTERIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos