{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:33:01Z","timestamp":1783949581648,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,8,28]],"date-time":"2018-08-28T00:00:00Z","timestamp":1535414400000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study is to identify the common microorganisms causing PJI as well as the drug\u2010resistant spectrum for each microorganism, to help orthopaedic surgeons to choose appropriate antibiotics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>One hundred and sixty patients who suffered from failure of primary or revision total hip or knee arthroplasty for different reasons were prospectively recruited. These patients underwent revision or re\u2010revision total hip or knee arthroplasty in our institution between August 2013 to August 2016. The details of patients\u2019 medical history and comprehensive physical examination, as well as demographic data were recorded precisely. Routine blood test results, erythrocyte sedimentation rate (ESR), C\u2010reactive protein (CRP), high sensitive C\u2010reactive protein (hs\u2010CRP), interleukin\u20106 (IL\u20106) levels, and synovial leukocyte counts were collected. Additionally, aspiration was conducted during surgery to avoid pollution unless when PJI was strongly suspected, in which case, joint puncture and aspiration were conducted before surgery. Intraoperatively, the implant\u2010surrounding tissue and the prosthesis were collected under aseptic conditions. Postoperatively, the prosthesis, implant\u2010surrounding tissue and synovium were sent to the laboratory immediately. The sonicate extraction (the prosthesis was sent for ultrasound sonication first), implant surrounding tissue and synovium were sent for microbiologic culture, and the implant\u2010surrounding tissue was also sent for pathological examination. The isolated bacteria strains and drug\u2010resistance rates for each pathogen for different antibiotics were presented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 59 PJI cases in the infectious group and 101 cases in the non\u2010infectious group (PJI is diagnosed according to the diagnosing criteria from the Workgroup of the Musculoskeletal Infection Society). Of 69 strains of pathogens isolated, Gram\u2010positive bacterium is the most common pathogenic bacteria causing PJI (60, 86.96%). <jats:italic>Staphylococcus epidermidis<\/jats:italic> and <jats:styled-content style=\"fixed-case\"><jats:italic>Staphylococcus aureus<\/jats:italic><\/jats:styled-content> played an important role as well, followed by Gram\u2010negative bacteria (8, 11.59%) and fungus (1, 1.45%). Penicillin (78.57%), erythromycin (66.67%) and clindamycin (44.74%) showed high antibiotic resistance rate. In addition, the second\u2010generation cephalosporin, usually as the prophylactic antibiotic, resistance rate was high (20%) as well. Fortunately, no vancomycin\u2010resistant bacteria were discovered in the current study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides some information on the most common pathogens in our institution and the selection of antibiotics in the perioperative period in northern China. Cefuroxime and clindamycin might not be appropriate for use as prophylactic antibiotics in revision total knee or hip arthroplasty. Vancomycin is ideal for empiric antibiotic use in suspected PJI cases because of the low drug\u2010resistance rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12394","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T02:08:42Z","timestamp":1535594922000},"page":"235-240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Identifying Common Pathogens in Periprosthetic Joint Infection and Testing Drug\u2010resistance Rate for Different Antibiotics: A Prospective, Single Center Study in Beijing"],"prefix":"10.1111","volume":"10","author":[{"given":"Zhang\u2010lai","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopedics Fuzhou Second Hospital of Xiamen University  Fuzhou China"},{"name":"Arthritis Clinic and Research Center Peking University People\u2019s Hospital  Beijing 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