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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

24.09.2023 | Knee Arthroplasty

Organism profile and C-reactive protein (CRP) response are different in periprosthetic joint infection in patients with hepatitis

verfasst von: Mustafa Akkaya, Serhat Akcaalan, Fabio Luigi Perrone, Nemandra Sandiford, Thorsten Gehrke, Mustafa Citak

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 1/2024

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Abstract

Purpose

Hepatitis B and C are important and relatively common health issues. It is known that many patients who underwent total knee and hip arthroplasty were also diagnosed with hepatitis. These patients are at higher risk of periprosthetic joint infection (PJI). This study aimed to investigate the differences in PJI cases in hepatitis B and C patients.

Methods

This is a retrospective case-controlled single-center study. A total of 270 patients with hepatitis and non-hepatitis (control group) who underwent one-stage septic exchange to the hip and knee joints were included in the study. All patients' previous surgical histories, infective organisms, C-reactive protein (CRP) values before septic exchange, and demographic data were evaluated. All microbiological and laboratory evaluations were performed separately for knee and hip arthroplasty.

Results

The mean CRP levels of Hep B- and C-positive patients, who underwent one-stage septic exchange in the knee joint, were 23.6 mg/L. In the control group, this value was 43.1 mg/L and a statistically significant difference was found between the groups (p = 0.004). Gram-negative organisms were identified in a larger proportion of patients with hepatitis who developed PJI in both hip and knee joints and underwent one-stage septic exchange (p = 0.041/p = 0.044).

Conclusion

PJIs caused by Gram-negative bacteria are encountered more frequently in patients with hepatitis than in the control group. In addition, the CRP rise is less in patients with hepatitis compared to PJI cases in the control group. Patient-specific evaluation is required in cases of PJI in patient groups with co-existing hepatitis.

McDermott KW, Liang L (2006) Overview of operating room procedures during inpatient stays in U.S. hospitals, 2018: statistical brief #281. Healthcare cost and utilization project (HCUP) statistical briefs

Singh JA, Yu S, Chen L, Cleveland JD (2019) Rates of total joint replacement in the United States: future projections to 2020–2040 using the national inpatient sample. J Rheumatol 46:1134–1140. https://doi.org/10.3899/JRHEUM.170990CrossRefPubMed

Kildow BJ, Politzer CS, DiLallo M et al (2018) Short and long-term postoperative complications following total joint arthroplasty in patients with human immunodeficiency virus, hepatitis B, or hepatitis C. J Arthroplasty 33:S86–S92.e1. https://doi.org/10.1016/J.ARTH.2017.10.061

Schweitzer A, Horn J, Mikolajczyk RT et al (2015) Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 386:1546–1555. https://doi.org/10.1016/S0140-6736(15)61412-XCrossRefPubMed

Gower E, Estes C, Blach S et al (2014) Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 61:S45–S57. https://doi.org/10.1016/J.JHEP.2014.07.027CrossRefPubMed

Zimmerli W, Trampuz A, Ochsner PE (2004) Prosthetic-joint infections. N Engl J Med. https://doi.org/10.1056/NEJMRA040181CrossRefPubMed

Kapadia BH, Berg RA, Daley JA et al (2016) Periprosthetic joint infection. Lancet 387:386–394. https://doi.org/10.1016/S0140-6736(14)61798-0CrossRefPubMed

Akgün D, Wiethölter M, Siegert P et al (2022) The role of serum C-reactive protein in the diagnosis of periprosthetic shoulder infection. Arch Orthop Trauma Surg 142:1715–1721. https://doi.org/10.1007/S00402-021-03779-2CrossRefPubMed

Sproston NR, Ashworth JJ (2018) Role of C-reactive protein at sites of inflammation and infection. Front Immunol. https://doi.org/10.3389/FIMMU.2018.00754CrossRefPubMedPubMedCentral

10.

Wang J, Zhao G, Chen J et al (2019) Association of hepatitis B infection with high-risk complications in total joint arthroplasty. BMC Musculoskelet Disord. https://doi.org/10.1186/S12891-019-2535-YCrossRefPubMedPubMedCentral

11.

Parvizi J, Tan TL, Goswami K et al (2018) The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 33:1309-1314.e2. https://doi.org/10.1016/J.ARTH.2018.02.078CrossRefPubMed

12.

Jenne CN, Kubes P (2013) Immune surveillance by the liver. Nat Immunol 14:996–1006. https://doi.org/10.1038/NI.2691CrossRefPubMed

13.

Sandler NG, Koh C, Roque A et al (2011) Host response to translocated microbial products predicts outcomes of patients with HBV or HCV infection. Gastroenterology. https://doi.org/10.1053/J.GASTRO.2011.06.063CrossRefPubMed

14.

Brandolini M, Corbella M, De Silvestri A et al (2015) Epidemiological characteristics of bloodstream infections in patients with different degrees of liver disease. Infection 43:561–567. https://doi.org/10.1007/S15010-015-0794-6CrossRefPubMed

15.

Parker R, Im G, Jones F et al (2017) Clinical and microbiological features of infection in alcoholic hepatitis: an international cohort study. J Gastroenterol 52:1192–1200. https://doi.org/10.1007/S00535-017-1336-ZCrossRefPubMedCentral

16.

Zhai XR, Tong JJ, Wang HM et al (2020) Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study. BMC Gastroenterol. https://doi.org/10.1186/S12876-020-01473-YCrossRefPubMedPubMedCentral

17.

Bjerke-Kroll BT, Christ AB, McLawhorn AS et al (2014) Periprosthetic joint infections treated with two-stage revision over 14 years: an evolving microbiology profile. J Arthroplasty 29:877–882. https://doi.org/10.1016/J.ARTH.2013.09.053CrossRefPubMed

18.

Tsai JC, Sheng WH, Lo WY et al (2015) Clinical characteristics, microbiology, and outcomes of prosthetic joint infection in Taiwan. J Microbiol Immunol Infect 48:198–204. https://doi.org/10.1016/J.JMII.2013.08.007CrossRefPubMed

19.

Villa JM, Pannu TS, Theeb I et al (2021) International organism profile of periprosthetic total hip and knee infections. J Arthroplasty 36:274–278. https://doi.org/10.1016/J.ARTH.2020.07.020CrossRefPubMed

20.

Bosco F, Cacciola G, Giustra F et al (2023) Characterizing recurrent infections after one-stage revision for periprosthetic joint infection of the knee: a systematic review of the literature. Eur J Orthop Surg Traumatol. https://doi.org/10.1007/S00590-023-03480-7CrossRefPubMedPubMedCentral

21.

Zimmerli W, Sendi P (2017) Orthopaedic biofilm infections. APMIS 125:353–364. https://doi.org/10.1111/APM.12687CrossRefPubMed

22.

Tande AJ, Patel R (2014) Prosthetic joint infection. Clin Microbiol Rev 27:302–345. https://doi.org/10.1128/CMR.00111-13CrossRefPubMedPubMedCentral

23.

Benito N, Mur I, Ribera A et al (2019) The different microbial etiology of prosthetic joint infections according to route of acquisition and time after prosthesis implantation, including the role of multidrug-resistant organisms. J Clin Med. https://doi.org/10.3390/JCM8050673CrossRefPubMedPubMedCentral

24.

Tai DBG, Patel R, Abdel MP et al (2022) Microbiology of hip and knee periprosthetic joint infections: a database study. Clin Microbiol Infect 28:255–259. https://doi.org/10.1016/J.CMI.2021.06.006CrossRefPubMed

25.

Parvizi J, Gehrke T (2014) Definition of periprosthetic joint infection. J Arthroplasty 29:1331. https://doi.org/10.1016/J.ARTH.2014.03.009CrossRefPubMed

26.

Saleh A, George J, Faour M et al (2018) Serum biomarkers in periprosthetic joint infections. Bone Jt Res 7:85–93. https://doi.org/10.1302/2046-3758.71.BJR-2017-0323CrossRef

27.

Kuo SJ, Huang PH, Chang CC et al (2016) Hepatitis B virus infection is a risk factor for periprosthetic joint infection among males after total knee arthroplasty: a Taiwanese nationwide population-based study. Medicine. https://doi.org/10.1097/MD.0000000000003806CrossRefPubMedPubMedCentral

28.

Baek JH, Lee SC, Ryu S et al (2022) Long-term outcomes of primary total knee arthroplasty in patients with hepatitis B virus infection. Bone Jt Open 3:470–474. https://doi.org/10.1302/2633-1462.36.BJO-2022-0030.R1CrossRefPubMedPubMedCentral

29.

Ross BJ, Cole MW, Ross AJ et al (2023) Hepatitis C is associated with higher short-term complication rates after initial aseptic and septic revision total hip arthroplasty: a matched cohort study. J Arthroplasty 38:548–554. https://doi.org/10.1016/J.ARTH.2022.09.018CrossRefPubMed

30.

Salter ML, Lau B, Mehta SH et al (2013) Correlates of elevated interleukin-6 and C-reactive protein in persons with or at high risk for HCV and HIV infections. J Acquir Immune Defic Syndr 64:488–495. https://doi.org/10.1097/QAI.0B013E3182A7EE2ECrossRefPubMed

31.

Shah S, Ma Y, Scherzer R et al (2015) Association of HIV, hepatitis C virus and liver fibrosis severity with interleukin-6 and C-reactive protein levels. AIDS 29:1325–1333. https://doi.org/10.1097/QAD.0000000000000654CrossRefPubMed

32.

Marnell L, Mold C, Du Clos TW (2005) C-reactive protein: ligands, receptors and role in inflammation. Clin Immunol 117:104–111. https://doi.org/10.1016/J.CLIM.2005.08.004CrossRef

Titel: Organism profile and C-reactive protein (CRP) response are different in periprosthetic joint infection in patients with hepatitis
verfasst von: Mustafa Akkaya
Serhat Akcaalan
Fabio Luigi Perrone
Nemandra Sandiford
Thorsten Gehrke
Mustafa Citak
Publikationsdatum: 24.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 1/2024
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-05059-7

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Organism profile and C-reactive protein (CRP) response are different in periprosthetic joint infection in patients with hepatitis