BACTERIOLOGICAL EVALUATION OF DEEP PERIPROSTHETIC INFECTION FOLLOWING TOTAL HIP JOINT ARTHROPLASTY
Résumé
Periprosthetic infection remains one of the most serious complications after total hip arthroplasty and is associated with prolonged treatment, repeated surgical interventions, and significant functional impairment. The aim of this study was to investigate the bacteriological spectrum of pathogens responsible for deep periprosthetic infection after total hip arthroplasty and to develop rational approaches to antimicrobial therapy based on microbiological findings.
A bacteriological (culture-based) examination was performed in 88 patients with purulent draining wounds complicated by periprosthetic infection following total hip arthroplasty. The microbial spectrum was studied, and pathogen identification with antimicrobial susceptibility testing was performed. Staphylococcus aureus was the predominant microorganism and was detected in 51 patients (57%). Other identified pathogens included Pseudomonas aeruginosa — 10 cases (11.3%), Staphylococcus haemolyticus — 9 cases (10.2%), Enterobacter spp. — 8 cases (9%), Staphylococcus epidermidis — 5 cases (5.6%), Escherichia coli — 4 cases (4.5%), and Klebsiella spp. — 1 case (1%). Mixed bacterial-fungal infection with Candida species was detected in 45 patients. Candida albicans was the most common fungal pathogen and contributed to biofilm formation and persistence of infection.
The study demonstrates that effective management of deep periprosthetic infection requires early diagnosis, radical surgical debridement, implant removal when indicated, antibiotic-loaded cement spacer implantation, and targeted antimicrobial therapy based on bacteriological results. The use of Microdacyn 60 superoxidized antiseptic solution promotes rapid elimination of microorganisms, preserves healthy tissues, and contributes to primary wound healing.
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