López-Contreras Joaquín, Duch Llorach Pol, Roch Villaverde Nerea, Almendral Alexander, López Ana Felisa, Marimon Marilo, Domínguez-Luzón M Angeles, Martinez-Pastor Jose Carlos, Ramoneda Salas Joan, Benito Natividad, Morata Laura, Zules-Oña Ricardo, Limón Enrique, Pujol Miquel
Infectious Diseases Division, Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
Infectious Diseases Division, Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2025 May;43 Suppl 1:S44-S51. doi: 10.1016/j.eimce.2025.02.015.
The VINCat program, established in Catalonia, Spain, in 2006, is a comprehensive infection prevention program for healthcare-associated infections. This study aims to analyze long-term trends in periprosthetic joint infections (PJI) following primary hip and knee arthroplasties over 15-year period (2008-2022).
PJI was defined according to CDC-NHSN criteria and updated in 2016 to incorporate the Musculoskeletal Infection Society classification. Data on PJI following total hip arthroplasty (THA), total knee arthroplasty (TKA), and hip hemiarthroplasty (HHA) were prospectively collected and analyzed across three periods: 2008-2012, 2013-2017, and 2018-2022.
Sixty-seven hospitals participated in the surveillance, reporting 189,063 procedures, including 61,267 THA (median age: 69 years, 47% female), 115,940 TKA (median age: 73 years, 68% female), and 11,856 HHA (median age: 86 years, 73% females). PJI incidence rates for THA were 0.9%, 1.1%, and 1.2% across the three periods (odds ratio (OR):1.14, 95% CI: 0.96-1.35). For TKA, rates were 0.9%, 1.0%, and 0.9% (OR:0.95, 95% CI: 0.83-1.09). The incidence of HHA-PJI declined from 3.4% to 2.3% and 1.8% (OR:0.77, 95% CI:0.58-1.03). Overall, the most common etiology was coagulase negative staphylococci followed by Staphylococcus aureus. PJIs were diagnosed after hospital discharge in 87.1% of THA, 89.6% of TKA, and 73.9% of HHA.
The incidence of PJI remains low despite an aging population undergoing orthopedic surgery, highlighting the effectiveness of current infection prevention strategies. A robust, long-term surveillance system is crucial for monitoring epidemiological trends and guiding the implementation of evidence-based preventive measures.
VINCat项目于2006年在西班牙加泰罗尼亚设立，是一项针对医疗保健相关感染的全面感染预防项目。本研究旨在分析15年期间（2008 - 2022年）初次髋关节和膝关节置换术后假体周围关节感染（PJI）的长期趋势。
PJI根据美国疾病控制与预防中心国家医疗安全网络（CDC - NHSN）标准定义，并于2016年更新，纳入了肌肉骨骼感染协会的分类。前瞻性收集并分析了全髋关节置换术（THA）、全膝关节置换术（TKA）和髋关节半关节置换术（HHA）后PJI在三个时间段的数据：2008 - 2012年、2013 - 2017年和2018 - 2022年。
67家医院参与了监测，报告了189,063例手术，其中包括61,267例THA（中位年龄：69岁，47%为女性）、115,940例TKA（中位年龄：73岁，68%为女性）和11,856例HHA（中位年龄：86岁，73%为女性）。THA在三个时间段的PJI发病率分别为0.9%、1.1%和1.2%（优势比（OR）：1.14，95%置信区间（CI）：0.96 - 1.35）。对于TKA，发病率分别为0.9%、1.0%和0.9%（OR：0.95，95% CI：0.83 - 1.09）。HHA - PJI的发病率从3.4%降至2.3%和1.8%（OR：0.77，95% CI：0.58 - 1.03）。总体而言，最常见的病因是凝固酶阴性葡萄球菌，其次是金黄色葡萄球菌。87.1%的THA、89.6%的TKA和73.9%的HHA的PJI在出院后被诊断出来。
尽管接受骨科手术的人群老龄化，但PJI的发病率仍然较低，这突出了当前感染预防策略的有效性。一个强大的长期监测系统对于监测流行病学趋势和指导实施循证预防措施至关重要。
