{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:10:58Z","timestamp":1788261058055,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T00:00:00Z","timestamp":1703548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Approximately 20% of patients after resection arthroplasty and antibiotic spacer placement for prosthetic joint infection develop repeat infections, requiring an additional antibiotic spacer before definitive reimplantation. The host and bacterial characteristics associated with the development of recurrent infection is poorly understood. A case\u2010control study was conducted for 106 patients with intention to treat by two\u2010stage revision arthroplasty for prosthetic joint infection at a single institution between 2009 and 2020. Infection was defined according to the 2018 Musculoskeletal Infection Society criteria. Thirty\u2010nine cases (\u201crecurrent\u2010periprosthetic joint infection\u00a0[PJI]\u201d) received at least two antibiotic spacers before clinical resolution of their infection, and 67 controls (\u201csingle\u2010PJI\u201d) received a single antibiotic cement spacer before infection\u2010free prosthesis reimplantation. Patient demographics, McPherson host grade, and culture results including antibiotic susceptibilities were compared. Fifty\u2010two (78%) single\u2010PJI and 32 (82%) recurrent\u2010PJI patients had positive intraoperative cultures at the time of their initial spacer procedure. The odds of polymicrobial infections were 11\u2010fold higher among recurrent\u2010PJI patients, and the odds of significant systemic compromise (McPherson host\u2010grade C) were more than double. Recurrent\u2010PJI patients were significantly more likely to harbor\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    . We found no differences between cases and controls in pathogen resistance to the six most tested antibiotics. Among recurrent\u2010PJI patients, erythromycin\u2010resistant infections were more prevalent at the final than initial spacer, despite no erythromycin exposure. Our findings suggest that McPherson host grade, polymicrobial infection, and\n                    <jats:italic>S. aureus<\/jats:italic>\n                    infection are key indicators of secondary or persistent joint infection following resection arthroplasty and antibiotic spacer placement, while bacterial resistance does not predict infection\u2010related arthroplasty failure.\n                  <\/jats:p>","DOI":"10.1002\/jor.25768","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T02:07:28Z","timestamp":1702519648000},"page":"560-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Host and microbial characteristics associated with recurrent prosthetic joint infections"],"prefix":"10.1002","volume":"42","author":[{"given":"Jessica P.","family":"Hampton","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"},{"name":"Stanford University School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne Y.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floriane Ngako","family":"Kameni","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7447-2463","authenticated-orcid":false,"given":"Joseph Raymund","family":"Espiritu","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Manasherob","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"},{"name":"Department of Orthopaedic Surgery, Stanford University Shoulder and Elbow Division Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"},{"name":"Department of Orthopaedic Surgery Joint Replacement Center Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James I.","family":"Huddleston","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"},{"name":"Department of Orthopaedic Surgery Joint Replacement Center Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Maloney","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"},{"name":"Department of Orthopaedic Surgery Joint Replacement Center Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-3717","authenticated-orcid":false,"given":"Stuart B.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"},{"name":"Department of Orthopaedic Surgery Joint Replacement Center Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6203-5853","authenticated-orcid":false,"given":"Derek F.","family":"Amanatullah","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Stanford University School of Medicine Redwood City California USA"},{"name":"Department of Orthopaedic Surgery Joint Replacement Center Redwood City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.03.066"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.02.046"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2018.03.025"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2020.12.021"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-021-04190-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151537"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01617"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-018-9504-1"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200210000-00003"},{"key":"e_1_2_8_11_1","first-page":"161","article-title":"Outcome of infected total knee utilizing a staging system for prosthetic joint infection","volume":"28","author":"McPherson EJ","year":"1999","journal-title":"American J\u00a0Orthopedics"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000088564.81746.62"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.02.078"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.12.005"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-25383-z"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.04.007"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.01.056"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro.2016.34"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001740"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics2020237"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.24019"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.femsim.2003.12.007"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/femsre\/fux004"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkt072"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCO.0b013e318230efcf"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.09.090"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2014.966290"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999.0000000000000050"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.09.021"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.25768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T09:25:39Z","timestamp":1709803539000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.25768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,26]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/jor.25768"],"URL":"https:\/\/doi.org\/10.1002\/jor.25768","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"value":"0736-0266","type":"print"},{"value":"1554-527X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,26]]},"assertion":[{"value":"2023-10-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}