Tande et al evaluated patients with Staphylococcus aureus bacteremia who developed a prosthetic joint infection (PJI). They identified patients who may benefit from more aggressive management. The authors are from the Mayo Clinic in Rochester.
Patient selection: Staphylococcus aureus bacteremia and one or more prosthetic joints
Almost all patients with Staphylococcus aureus PJI associated with bacteremia had one or more clinical findings suggested of PJI, especially pain and swelling. The occurrence of occult PJI was considered rare.
Factors associated with a higher risk for prosthetic joint infection:
(1) community-acquired bacteremia (odds ratio 21.4) versus community-onset healthcare associated (odds ratio 5.9)
(2) multiple joint prostheses (3 or more)
(3) knee prosthesis
(4) previous arthroplasty revision
Factors not associated with an increased risk for prosthetic joint infection:
(1) immunocompromised status
(2) nosocomial Staphylococcus aureus bacteremia
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