Panev Atanas, Ivanov Ivan, Georgiev Georgi P, Gaydarski Lyubomir, Kinov Plamen
Department of Orthopaedics and Traumatology, University Hospital Queen Giovanna - ISUL, Sofia, BGR.
Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, BGR.
Cureus. 2024 Nov 2;16(11):e72868. doi: 10.7759/cureus.72868. eCollection 2024 Nov.
Periprosthetic joint infection (PJI) is a rare yet serious complication following a total hip replacement, predominantly caused by gram-positive bacteria such as and However, gram-negative pathogens can also be isolated. This case report presents a 22-year-old patient with a PJI caused by after total hip replacement due to a motor vehicle accident. The patient with a clinical history of total hip replacement secondary to posttraumatic arthrosis presented to our department with clinical and laboratory indications of PJI in the right hip. Microbiological samples revealed , a multidrug-resistant gram-negative pathogen. A two-stage revision with a double spacer exchange procedure was performed. Antibiotic treatment with prolonged meropenem infusion via an infusion pump was administered. After two years of follow-up, no signs of infection were observed. The exchange spacer procedure with prolonged antibiotic administration for the treatment of difficult-to-treat pathogens causing PJI is a high-risk procedure associated with significant mortality. Nevertheless, for young patients with robust reparative capabilities, it may be considered a viable therapeutic option.
人工关节周围感染（PJI）是全髋关节置换术后一种罕见但严重的并发症，主要由革兰氏阳性菌如[具体细菌名称1]和[具体细菌名称2]引起。然而，革兰氏阴性病原体也可能被分离出来。本病例报告介绍了一名22岁的患者，在因机动车事故进行全髋关节置换术后发生了由[具体细菌名称3]引起的PJI。该患者有创伤后关节炎继发全髋关节置换的病史，因右髋出现PJI的临床和实验室指征前来我院就诊。微生物样本显示为[具体细菌名称3]，一种耐多药革兰氏阴性病原体。进行了两阶段翻修及双间隔物置换手术。通过输液泵延长美罗培南输注时间进行抗生素治疗。经过两年的随访，未观察到感染迹象。对于因引起PJI的难治性病原体采用延长抗生素给药的间隔物置换手术是一种与显著死亡率相关的高风险手术。然而，对于具有强大修复能力的年轻患者，它可能被认为是一种可行的治疗选择。
