The effect of rifampicin-resistance and other risk factors on the recovery rate in patients with prosthetic joint infection
Krizsán Gergely
Surgical Medicine Division
Dr. Szijártó Attila
NET Tanácsterem
2024-05-13 14:00:00
Physiology and Pathology of the Musculoskeletal System
Dr. Szőke György
Dr. Skaliczki Gábor
Dr. Kiss Sándor
Dr. Hangody László Rudolf
Dr. Szőke György
Dr. Lakatos Botond Tibor
Dr. Bartha Lajos
Rifampicin plays a key role in the management of prosthetic joint infections (PJIs), however, the emergence of rifampicin-resistance is associated with less favorable clinical outcomes. Patient-specific data, comorbidities and the antibiotic resistance of microbiological isolates were collected and reviewed. Obtained data were statistically analysed with a logistic regression model. The first aim of our study was to investigate the impact of rifampicin-resistance and other patient-related factors on recovery rates among patients with PJI undergoing two-stage revision. We reviewed medical records and microbiology reports of 73 patients undergoing two-stage revision due to PJI between 2017 and 2019. Rifampicin-sensitive microorganism was isolated in 53 cases (72.6%). Recovery rate was 92.5% in the sensitive and 60.0% in the resistant group. In the rifampicin-sensitive group, the probability of recovery decreased with advancing age with a significant drop above the age of 60 years. The effect of age is negligible in the rifampicin-resistant group. We also found that type 2 diabetes mellitus has a negative effect on recovery whereas higher recovery was observed among males. Coagulase-negative Staphylococcus spp. were predominant in the rifampicin-sensitive (50.0% of the isolates) and Gram-negative rods in the resistant group (40.0%). The second aim of our study was to investigate the impact of rifampicin-resistance and other patient-related factors on recovery rates among patients with PJI undergoing DAIR (Debridement, Antibiotics and Implant Retention) procedure. We collected and reviewed medical records and microbiology reports of 67 patients undergoing DAIR due to PJI between 2014 and 2021. Rifampicin-sensitive microorganism was isolated in 47 cases. Recovery rate was 72.3% in the sensitive and 76.9% in the resistant group. Based on our results, higher age and diabetes mellitus may have a clinically relevant negative impact on clinical outcome, however, this effect was not statistically significant. We observed no clinically relevant effect of rifampicin-resistance, sex and body mass index (BMI) on recovery rates among patients undergoing DAIR due to PJI. Staphylococcus aureus and coagulase-negative Staphylococcus spp. were predominant in the rifampicin-sensitive (66.6% of the isolates) and Gram-negative rods in the resistant group (65.2%).
