Periprosthetic joint infections in a city hospital in Türkiye: A cross-sectional study

Increased life expectancy increases the risk of osteoarthritis and sustaining fractures. Prosthetic surgery is the primary treatment for such conditions. Periprosthetic joint infections (PJI) are the principal cause of failure of arthroplasty. This study aimed to mitigate the incidence of PJI by identifying the predominant risk factors and causative microorganisms associated with PJI at our institution. Surgeries for total hip arthroplasty (THA) and total knee arthroplasty (TKA) conducted at the Orthopedic and Traumatology Clinic were retrospectively reviewed. Patient' demographic data, reproductive factors, and antibiotic resistance profiles were evaluated. Categorical variables are expressed as frequencies and percentages, while continuous variables with non-normal distributions are presented as median values. Within a span of 7 years, 300 THA and TKA procedures were performed, resulting in 18 patients developing surgical site infections attributed to 24 discrete factors. Of these patients, 15 (83.3%) were female and 3 (16.7%) were male. The age range of the affected individuals was 23 to 93 years, with a median age of 74 years. Sixteen patients underwent THA (89%), whereas the others underwent TKA. The mean duration of hospitalization was 46 days. The predominant risk factors identified were advanced age, female sex, and use of peripheral venous catheters. Microbial cultures revealed an 83.4% prevalence of Gram-negative bacteria and a 16.6% prevalence of Gram-positive bacteria. Escherichia coli and Acinetobacter baumannii were the most frequently isolated microorganisms. PJIs present a diagnostic challenge and often require prolonged treatment. Importantly, the prevention of PJIs is not only more straightforward but also significantly more cost-effective than treatment. Establishing laminar airflow in the operating room, limiting personnel traffic, implementing institution-specific infection prevention protocols, and providing feedback to staff can reduce the incidence of PJIs. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.