Table 2.
Characteristics of 132 Hematogenous PJI Episodes
| Characteristic | Episodes (n = 132) |
|---|---|
| Affected prosthesis | |
| Knee | 76 (58) |
| Hip | 54 (41) |
| Shoulder | 1 (1) |
| Elbow | 1 (1) |
| Time from last surgery to infection, median (range), y | 2.5 (0.1–28.8) |
| Time from primary implantation to infection, median (range), y | 9.9 (0.1–34.6) |
| Acute manifestation (<4 wk symptom duration) | 98/129 (76) |
| Occurrence of infection after last surgery | |
| Early (<3 mo) | 17/130 (13) |
| Delayed (3–24 mo) | 43/130 (33) |
| Late (>24 mo) | 70/130 (54) |
| Clinical findings at admission | |
| New onset of joint pain after an uneventful course | 124/128 (97) |
| Local signs of inflammationa | 89/129 (69) |
| Fever (>38°C) | 46/126 (37) |
| Radiological findings at admission | |
| Implant loosening | 21 (16) |
| Laboratory findings at admission | |
| Serum C-reactive protein concentration, median (range), mg/L | 148 (3–579) |
| Synovial fluid leukocyte count, median (range), 109/L | 67.9 (0.8–2215.5) |
| Microbiologyb | |
| Staphylococcus aureusc | 49 (37) |
| Streptococcid | 36 (27) |
| Enterococcie | 17 (13) |
| Gram-negative rodsf | 16 (12) |
| S. epidermidis | 9 (7) |
| Clostridium spp.g | 2 (2) |
| Candia albicans | 2 (2) |
| Culture negative | 2 (2) |
| Portal of pathogen entry/primary infection focus | |
| Unknown | 39 (30) |
| Cardiovascular | 32 (24) |
| Urogenital tract | 18 (14) |
| Skin | 17 (13) |
| Oral cavity | 15 (11) |
| Gastrointestinal tract | 8 (6) |
| Otherh | 3 (2) |
Data are No. (%) of episodes, if not indicated otherwise.
Abbreviation: PJI, periprosthetic joint infection.
Including swelling, erythema, warmth at the index joint.
One mixed infection (S. agalactiae and E. coli); therefore, the sum exceeds 100%.
Including 7 methicillin-resistant S. aureus strains.
Including Streptococcus agalactiae (n = 13), S. dysgalactiae (n = 10), S. oralis/mitis (n = 5), S. gallolyticus (n = 3), S. gordonii (n = 2), S. anginosus (n = 2) S. canis, S. constellatus, S. pyogenes, S. sanguinis, and S. parasanguinis (n = 1 each). One patient had mixed streptococcal infection.
Including E. faecalis (n = 15), E. faecium (n = 2).
Including Escherichia coli (n = 9), Proteus mirabilis (n = 3), Campylobacter coli (n = 1), Haemophilus parainfluenzae (n = 1), Enterobacter cloacae (n = 1), Pseudomonas aeruginosa (n = 1).
Clostridium innocuum (n = 1), C. perfringens (n = 1).
Epidural abscess and meningitis (n = 1), contralateral PJI (n = 1), pneumonia (n = 1).