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Update on infections in articular prosthesis

The implantation of artificial joints, especially the hip and knee, is becoming increasingly common, representing a significant reduction in discomfort and an immeasurable improvement in patient mobility. Reviews of the global literature indicate that 1-5% of these grafts become infected, though it is important to remember that, as the number of surgeries for implantation of these prosthesis grows, so will the number of cases of this type of infection. Gram-positive bacteria predominate in the contamination of joint prosthesis, in particular Staphylococcus aureus and Staphylococcus epidermidis. Infections caused by gram-negative bacilli and fungi such as Candida sp have been reported with increased frequency throughout the world. Infections of joint prosthesis have characteristic signals that can be divided into acute (severe pain, high fever, toxemia, heat, redness, and wound secretion) and chronic (progressive pain, cutaneous fistula formation, with pus drainage, no fever) manifestations. The definitive diagnosis of the infection should be made through the isolation in culture of the micro-organism obtained from the puncture of the joint fluid, surgical wound secretion, and material collected during surgical debridement. It is essential to cover methicillin-resistant Staphylococcus aureus, given the epidemiological importance of this agent in these infections. The total time of antibiotic therapy varies from six weeks to six months, and that treatment should be adjusted as needed, based on the results of culturing.

Joint Prosthesis; Infection; Infection


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