Periprosthetic joint infection (PJI) is a serious complication after total joint arthroplasty. In the course of a PJI, superinfections with pathogens that do not match the primary infecting micro-organism may occur. To our knowledge, there are no published data on the outcome of such infections in the literature. The aim of this study was to assess the outcome of PJI with superinfections with a difficult-to-treat (DTT) pathogen. Data of 169 consecutive patients with PJI were retrospectively analyzed in this single-center study. Cases were categorized into: Group 1 including non-DTT-PJI without superinfection, Group 2 DTT-PJI without superinfection, Group 3 non-DTT-PJI with DTT superinfection, and Group 4 non-DTT-PJI with non-DTT superinfection. Group 3 comprised 24 patients and showed, after a mean follow-up of 13.5 ± 10.8 months, the worst outcome with infection resolution in 17.4% of cases (p = 0.0001), PJI-related mortality of 8.7% (p = 0.0001), mean revision rate of 6 ± 3.6 (p < 0.0001), and duration of antibiotic treatment of 71.2 ± 45.2 days (p = 0.0023). PJI caused initially by a non-DTT pathogen with a superinfection with a DTT pathogen is significantly associated with the worst outcome in comparison to non-DTT-PJI, PJI caused initially by a DTT pathogen, and to non-DTT-PJI with a non-DTT superinfection.

中文翻译：

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难治性病原体的双重感染显着降低了假体周围关节感染的结果

假体周围关节感染（PJI）是全关节置换术后的严重并发症。在 PJI 的过程中，可能会发生病原体与主要感染微生物不匹配的双重感染。据我们所知，文献中没有关于此类感染结果的已发表数据。本研究的目的是评估 PJI 与难治性 (DTT) 病原体重复感染的结果。在这项单中心研究中，对 169 名连续 PJI 患者的数据进行了回顾性分析。病例分为：第1组包括无双重感染的非DTT-PJI，第2组没有双重感染的DTT-PJI，第3组有DTT双重感染的非DTT-PJI和第4组有非DTT双重感染的非DTT-PJI。第 3 组包括 24 名患者，平均随访 13.5 ± 10.8 个月后，p = 0.0001)，PJI 相关死亡率为 8.7% ( p = 0.0001)，平均翻修率为 6 ± 3.6 ( p < 0.0001)，抗生素治疗持续时间为 71.2 ± 45.2 天 ( p = 0.0023)。与非 DTT-PJI、最初由 DTT 病原体引起的 PJI 和非 DTT-PJI 与非 DTT-PJI 相比，最初由非 DTT 病原体与 DTT 病原体引起的 PJI 与最坏的结果显着相关。 -DTT 双重感染。