Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure
Objective:
The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptibleS. aureus (MSSA) prosthetic joint infection (PJI) is not well-known.Patients and methods:
Retrospective (2000–2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Coxanalysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure.Results:
Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associatedwith treatment failure (hazard ratio 2.157; 95% CI [1.022–4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy,and a rifampicin-based regimen did not significantly influence patient outcome.Conclusion:
Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implantremoval is needed to limit treatment failure.