In patients with pelvic endoprostheses affected by infection following tumor resection, infections were mostly polymicrobial flora, caused by gram-negative microorganisms and may be correlated with intestinal flora, according to recently published results.
“The epidemiology of micro-organisms cultured after infection of pelvic reconstructions differ fundamentally from mono-bacterial gram-positive causes of conventional prosthetic joint infections. Therefore, current prophylactics and empiric treatment may need to be changed,” Philip T.J. Sanders, MD, told Healio.com/Orthopedics.
Researchers identified 70 patients who underwent endoprosthetic reconstruction in periacetabular tumor resection. Of the 70 patients, 18 patients developed an infection. The median follow-up was 66 months. Investigators recorded the microorganisms isolated during first debridement. The number of reoperations for ongoing infection, antimicrobial treatment strategy and the outcome of the treatment were also recorded.
Results showed 18 patients with infection had polymicrobial infection. In 12 patients, investigators identified Enterobacteriaceae on culture. The identified pathogen was gram-negative in 26 instances out of the 42 times a microorganism was isolated. Microorganisms correlated with intestinal flora were identified 32 times.
There were nine patients who had the original implant in situ at the latest follow-up, of which two patients had a fistula and two patients received suppressive antibiotic therapy. The original implant had been removed in the nine remaining patients, of which three patients had a second implant in situ. Secondary reconstruction was not needed in the six-remaining patients. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.