Intraoperative bacterial contamination and activity of different antimicrobial prophylaxis regimens in primary knee and hip replacement

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• dc.contributor.author Rivera, Alba
• dc.contributor.author Sánchez, Alba
• dc.contributor.author Luque Pardos, Sònia
• dc.contributor.author Mur, Isabel
• dc.contributor.author Puig, Lluís
• dc.contributor.author Puig, Lluís
• dc.contributor.author Crusi, Xavier
• dc.contributor.author González, José Carlos
• dc.contributor.author Sorli Redó, M. Luisa
• dc.contributor.author González, Aránzazu
• dc.contributor.author Horcajada Gallego, Juan Pablo
• dc.contributor.author Navarro, Ferran
• dc.contributor.author Benito, Natividad
• dc.date.accessioned 2021-10-11T06:33:34Z
• dc.date.available 2021-10-11T06:33:34Z
• dc.date.issued 2020
• dc.description.abstract Surgical antimicrobial prophylaxis (SAP) is important for the prevention of prosthetic joint infections (PJIs) and must be effective against the microorganisms most likely to contaminate the surgical site. Our aim was to compare different SAP regimens (cefazolin, cefuroxime, or vancomycin, alone or combined with gentamicin) in patients undergoing total knee (TKA) and hip (THA) arthroplasty. In this preclinical exploratory analysis, we analyzed the results of intraoperative sample cultures, the ratio of plasma antibiotic levels to the minimum inhibitory concentrations (MICs) for bacteria isolated at the surgical wound and ATCC strains, and serum bactericidal titers (SBT) against the same microorganisms. A total of 132 surgical procedures (68 TKA, 64 THA) in 128 patients were included. Cultures were positive in 57 (43.2%) procedures (mostly for coagulase-negative staphylococci and Cutibacterium spp.); the rate was lower in the group of patients receiving combination SAP (adjusted OR 0.475, CI95% 0.229-0.987). The SAP regimens evaluated achieved plasma levels above the MICs in almost all of intraoperative isolates (93/94, 98.9%) and showed bactericidal activity against all of them (SBT range 1:8-1:1024), although SBTs were higher in patients receiving cefazolin and gentamicin-containing regimens. The potential clinical relevance of these findings in the prevention of PJIs remains to be determined.
• dc.format.mimetype application/pdf
• dc.identifier.citation Rivera A, Sánchez A, Luque S, Mur I, Puig L, Crusi X, et al. Intraoperative bacterial contamination and activity of different antimicrobial prophylaxis regimens in primary knee and hip replacement. Antibiotics (Basel). 2020 Dec 27;10(1):18. DOI: 10.3390/antibiotics10010018
• dc.identifier.doi http://dx.doi.org/10.3390/antibiotics10010018
• dc.identifier.issn 2079-6382
• dc.identifier.uri http://hdl.handle.net/10230/48630
• dc.language.iso eng
• dc.publisher MDPI
• dc.rights Copyright © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Antibiotic levels
• dc.subject.keyword Hip arthroplasty
• dc.subject.keyword Intraoperative cultures
• dc.subject.keyword Knee arthroplasty
• dc.subject.keyword Prosthetic joint infection
• dc.subject.keyword Prosthetic joint infection prevention
• dc.subject.keyword Serum bactericidal titer
• dc.subject.keyword Surgical antimicrobial prophylaxis
• dc.subject.keyword Surgical site infection prevention
• dc.title Intraoperative bacterial contamination and activity of different antimicrobial prophylaxis regimens in primary knee and hip replacement
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion