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Preoperative and perioperative risk factors, and risk score development for prosthetic joint infection due to Staphylococcus aureus: a multinational matched case-control study
Authors/contributors
- Espindola, Reinaldo (Author)
- Vella, Venanzio (Author)
- Benito, Natividad (Author)
- Mur, Isabel (Author)
- Tedeschi, Sara (Author)
- Rossi, Nicolò (Author)
- Hendriks, Johannes G.E. (Author)
- Sorlí, Luisa (Author)
- Murillo, Oscar (Author)
- Scarborough, Mathew (Author)
- Scarborough, Claire (Author)
- Kluytmans, Jan (Author)
- Ferrari, Mateo Carlo (Author)
- Pletz, Mathias W. (Author)
- Mcnamara, Iain (Author)
- Escudero-Sanchez, Rosa (Author)
- Arvieux, Cedric (Author)
- Batailler, Cecile (Author)
- Dauchy, Frédéric-Antoine (Author)
- Liu, Wai-Yan (Author)
- Lora-Tamayo, Jaime (Author)
- Praena, Julia (Author)
- Ustianowski, Andrew (Author)
- Cinconze, Elisa (Author)
- Pellegrini, Michele (Author)
- Bagnoli, Fabio (Author)
- Rodríguez-Baño, Jesús (Author)
- Del Toro, Maria Dolores (Author)
- Cuperus, Nienke (Author)
- Manfré, Giuseppe (Author)
- Zamparini, Eleonora (Author)
- Verhagen, Stéphanie (Author)
- Horcajada, Juan P. (Author)
- Junyent, Joan Gómez (Author)
- Alier, Albert (Author)
- Soldevila, Laura (Author)
- Van Rijen, Miranda (Author)
- Romme, Jannie (Author)
- Ankert, Juliane (Author)
- Whitehouse, Celia (Author)
- Jones, Adrian (Author)
- Cobo, Javier (Author)
- Moreno, Javier (Author)
- Meheut, Anne (Author)
- Gledel, Claire (Author)
- Perreau, Pauline (Author)
- Van Wensen, Remco J.A. (Author)
- Lindergard, Gabriella (Author)
Abstract
Objectives
We aim to identify the preoperative and perioperative risk factors associated with post-surgical Staphylococcus aureus prosthetic joint infections (PJI) and to develop and validate risk-scoring systems, to allow a better identification of high-risk patients for more efficient targeted interventions.
Methods
We performed a multicenter matched case-control study of patients who underwent a primary hip and knee arthroplasty from 2014 to 2016. Two multivariable models by logistic regression were performed, one for the preoperative and one for perioperative variables; predictive scores also were developed and validated in an external cohort.
Results
In total, 130 cases and 386 controls were included. The variables independently associated with S. aureus-PJI in the preoperative period were (adjusted OR; 95% CI): body mass index >30 kg/m2 (3.0; 1.9 to 4.8), resident in a long-term care facility (2.8; 1.05 to 7.5), fracture as reason for arthroplasty (2.7; 1.4 to 5.03), skin disorders (2.5; 0.9 to 7.04), previous surgery in the index joint (2.4; 1.3 to 4.4), male sex (1.9; 1.2 to 2.9) and American Society of Anesthesiologists index score 3 to 4 (1.8; 1.2 to 2.9). The area under the receiver operating characteristic curve was 0.73 (95% CI 0.68 to 0.78). In perioperative model, the risk factors were the previous ones plus surgical antibiotic prophylaxis administered out of the first 60 minutes before incision (5.9; 2.1 to 16.2), wound drainage for >72 hours after arthroplasty (4.5; 1.9 to 19.4) and use of metal bearing material versus ceramic (1.9; 1.1 to 3.3). The area under the receiver operating characteristic curve was 0.78 (95% CI 0.72 to 0.83). The predictive scores developed were validated in the external cohort.
Discussion
Predictive scores for S. aureus-PJI were developed and validated; this information would be useful for implementation of specific preventive measures.
Publication
Clinical Microbiology and Infection
Date
10/2022
Citation
1.
Espindola R, Vella V, Benito N, et al. Preoperative and perioperative risk factors, and risk score development for prosthetic joint infection due to Staphylococcus aureus: a multinational matched case-control study. Clinical Microbiology and Infection. 2022;28(10):1359-1366.
Section
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