ArticlePloS one2019
Obese patients have higher rates of polymicrobial and Gram-negative early periprosthetic joint infections of the hip than non-obese patients.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- The Impact of Sex on the Outcomes of Prosthetic Joint Infection Treatment with Debridement, Antibiotics and Implant Retention: A Systematic Review and Individual Patient Data Meta-analysis.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2022Pooled it
- Only a partial shield: local vancomycin postpones but does not prevent hip and knee prosthetic infections.Archives of orthopaedic and trauma surgery · 2026Article
- Article
- Molecular diagnostics for perioperative microbial identification in periprosthetic joint infection: A scoping review and proposal of a diagnostic flow chart.Journal of experimental orthopaedics · 2025Review
- Article
- Does obesity affect the diagnostic value of various biomarkers for periprosthetic joint infections? A single center retrospective study.Frontiers in cellular and infection microbiology · 2025Article
- Effect of weight-adjusted antimicrobial antibiotic prophylaxis on postoperative dosage and surgical site infection incidence in total joint arthroplasty.World journal of orthopedics · 2024Article
- Decreased Risk of Periprosthetic Joint Infection with Concurrent Hardware Removal During Conversion Total Hip Arthroplasty Compared to Staged Removal: A Matched Cohort Analysis.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Article
- Racial Disparities in Periprosthetic Joint Infections after Primary Total Joint Arthroplasty: A Retrospective Study.Antibiotics (Basel, Switzerland) · 2023Article
- Cultures in periprosthetic joint infections, the imperfect gold standard?EFORT open reviews · 2023Review
- Gut permeability may be associated with periprosthetic joint infection after total hip and knee arthroplasty.Scientific reports · 2022Article
- Fracture Related Infections and Their Risk Factors for Treatment Failure-A Major Trauma Centre Perspective.Diagnostics (Basel, Switzerland) · 2022Article
- Positivity Trends of Bacterial Cultures from Cases of Acute and Chronic Periprosthetic Joint Infections.Journal of clinical medicine · 2022Article
- Article
- Septic Arthritis Complicating Arthroscopic Anterior Cruciate Ligament Reconstruction: An Experience from a Tertiary-Care Hospital.Infection and drug resistance · 2022Article
- Fatal Clostridium Infection in a Leg-Amputated Patient after Unsuccessful Knee Arthroplasty.International journal of environmental research and public health · 2021Article
- Infection Risk-Adjusted Antibiotic Prophylaxis Strategies in Arthroplasty: Short Review of Evidence and Experiences of a Tertiary Center in Spain.Orthopedic research and reviews · 2020Review
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObese patients are more likely to develop periprosthetic joint infection (PJI) after primary total joint arthroplasty. This study compared the clinical and microbiological characteristics of non-obese, obese and severely obese patients with early PJI, in order to ultimately optimize antibiotic prophylaxis and other prevention measures for this specific patient category.
methodsWe retrospectively evaluated patients with early PJI of the hip and knee treated with debridement, antibiotics and implant retention (DAIR) between 2006 and 2016 in three Dutch hospitals. Only patients with primary arthroplasties indicated for osteoarthritis were included. Early PJI was defined as an infection that developed within 90 days after index surgery. Obesity was defined as a BMI ≥30kg/m2 and severe obesity as a BMI ≥35kg/m2.
resultsA total of 237 patients were analyzed, including 64 obese patients (27.0%) and 62 severely obese patients (26.2%). Compared with non-obese patients, obese patients had higher rates of polymicrobial infections (60.3% vs 33.3%, p<0.001) with more often involvement of Enterococcus species (27.0% vs 11.7%, p = 0.003). Moreover, severely obese patients had more Gram-negative infections, especially with Proteus species (12.9% vs 2.3%, p = 0.001). These results were only found in periprosthetic hip infections, comprising Gram-negative PJIs in 34.2% of severely obese patients compared with 24.7% in obese patients and 12.7% in non-obese patients (p = 0.018).
conclusionsOur results demonstrate that obese patients with early periprosthetic hip infections have higher rates of polymicrobial infections with enterococci and Gram-negative rods, which stresses the importance of improving preventive strategies in this specific patient category, by adjusting antibiotic prophylaxis regimens, improving disinfection strategies and optimizing postoperative wound care.
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