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Microbiological Spectrum, Antibiotic Resistance And Clinical Outcomes Of Prosthetic Joint Infections

Authors

Aqsa Aslam
Associate Professor, Department of Pathology, Rawal Institute of Health Sciences, Islamabad
Farooq Azam Khan
Professor & Head, Department of Orthopedic Surgery
Muhammad Kashif Jamal
Senior Registrar, Department of Orthopedic Surgery
Bilal Ahmad Abbas
Assistant Professor, Department of Orthopedic Surgery
Sadaf Nasir
Assistant Professor Microbiology, Department of Pathology, Rawal Institute of Health Sciences, Islamabad
Maria Aslam
Professor & Head, Department of Pathology, Sharif Medical City Hospital, Lahore

Abstract

Objective:
To determine the frequency of prosthetic joint infections (PJIs), causative organisms, their antimicrobial susceptibility profile, and clinical outcomes in patients who underwent joint replacement
Study Design:
Descriptive, cross-sectional study.
Place and Duration of Study:
Sharif Medical City Hospital and Alrazi Healthcare Hospital, Lahore, 04 years (January 2021 to December 2025).
Patients and Methods:
The study was done after obtaining the ethical approval. A total of 843 patients with severe joint disease, who met the eligibility criteria for joint replacement surgery, were enrolled written, informed using a nonprobability convenience sampling technique. A written, informed consent was obtained from the participants. Patients received a single preoperative dose of secondgeneration cephalosporin and a post-operative broad-spectrum oral antibiotic for 1 week. Patients were followed up at 2 weeks, 6 weeks, and 3 months. For patients with PJIs, the causative organisms were isolated on culture, and their antimicrobial susceptibility was tested. Patients were treated either by using debridement, antibiotics and implant retention (DAIR) or two-staged revision. The Statistical Package for the Social Sciences version 27 was used for statistical analysis.
Results:
Fifteen (1.8%) patients developed PJIs. Out of 15 infected cases, 7(46.7%) were Staphylococcus aureus, 4(26.6%) were Coagulase-negative Staphylococci(CoNS), 2(13.3%) were Streptococcus species, 1(6.7%) was Pseudomonas aeruginosa, and 1(6.7%) was E. coli. Three (42.9%) isolates of Staphylococcus aureus were methicillin-resistant Staphylococcus aureus (MRSA), while 4(57.1%) were methicillin-sensitive(MSSA). E. coli and Pseudomonas showed no resistance to imipenem, meropenem, and tazocin. Sixty and forty percent of the patients underwent DAIR and two-staged revision, respectively, and recovered completely. The incidence of PJIs was associated with advanced age and diabetes mellitus (p-value = 0.01).
Conclusion:
Prosthetic joint infection occurred in 1.8% of joint replacement cases, with gram-positive cocci being the predominant pathogens. Vancomycin, linezolid, tigecycline, carbapenems, and piperacillin-tazobactam showed excellent antimicrobial efficacy. Both DAIR and two-stage revision were effective treatment strategies. Advanced age and diabetes mellitus were important risk factors for PJI.
Kewords:
Joint Prosthesis; Microbial Drug Resistance; Staphylococcus aureus.

How to cite this article

Aslam A, Khan FA, Jamal MK, Abbas BA, Nasir S, Aslam M. Microbiological Spectrum, Antibiotic Resistance and Clinical Outcomes of Prosthetic Joint Infections. HMDJ. 2026 June; 06(01): 34-39.
DOI: https://doi.org/10.69884/hmdj.6.1.0912

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