Institute of Medical Microbiology and Hygiene, University of Saarland Hospital, Homburg, Germany.
Int J Med Sci. 2009 Sep 2;6(5):234-40. doi: 10.7150/ijms.6.234.
Infections of the hip joint are usually of bacterial etiology. Only rarely, an infectious arthritis is caused in this localization by viruses or fungi. Native joint infections of the hip are less common than infections after implantation of prosthetic devices. Difficulties in prosthetic joint infections are, (I) a higher age of patients, and, thus an associated presence of other medical risk factors, (II) often long courses of treatment regimes depending on the bacterium and its antibiotic resistance, (III) an increased mortality, and (IV) a high economic burden for removal and reimplantation of an infected prosthetic device. The pathogenic mechanisms responsible for articular infections are well studied only for some bacteria, e.g. Staphylococcus aureus, while others are only partially understood. Important known bacterial properties and microbiological characteristics of infection are the bacterial adhesion on the native joint or prosthetic material, the bacterial biofilm formation, the development of small colony variants (SCV) as sessile bacterial types and the increasing resistance to antibiotics.
髋关节感染通常为细菌性病因。只有极少数情况下，病毒或真菌会导致该部位感染性关节炎。髋关节原发性关节感染比人工植入设备后的感染少见。人工植入设备后的感染存在以下难点：（I）患者年龄较大，同时存在其他医疗风险因素，（II）根据细菌及其抗生素耐药性，通常需要长期治疗方案，（III）死亡率增加，（IV）移除和重新植入感染的人工植入设备会带来较高的经济负担。只有某些细菌（例如金黄色葡萄球菌）的关节感染发病机制得到了深入研究，而其他细菌的发病机制仅部分被理解。已被了解的重要细菌特性和感染的微生物学特征包括：细菌在原生关节或人工材料上的黏附、细菌生物膜形成、小菌落变异体（SCV）作为静止细菌类型的出现，以及抗生素耐药性的增强。
