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00925njm 22002777a 4500 dc Benito, Natividad author Mur, Isabel author Ribera, Alba author Soriano, Alex author Rodriguez-Pardo, Dolors author Sorli, Luisa author Cobo, Javier author Fernandez-Sampedro, Marta author del Toro, Maria Dolores author Guio, Laura author Praena, Julia author Bahamonde, Alberto author Riera, Melchor author Esteban, Jaime author Mirena Baraia-Etxaburu, Josu author Martinez-Alvarez, Jesus author Jover-Saenz, Alfredo author Dueñas, Carlos author Ramos, Antonio author Sobrino, Beatriz author Euba, Gorane author Morata, Laura author Pigrau, Carles author Horcajada, Juan P author Coll, Pere author Crusi, Xavier author Ariza, Javier author REIPI (Spanish Network for Research in Infectious Disease) Group for the Study of Prosthetic Joint Infections/GEIO (Group for the Study of Osteoarticular Infections) author SEIMC (Spanish Society of Infectious Diseases and Clinical Microbiology) author 2019-05 The aim of our study was to characterize the etiology of prosthetic joint infections (PJIs)including multidrug-resistant organisms (MDRO)by category of infection. A multicenter study of 2544 patients with PJIs was performed. We analyzed the causative microorganisms according to the Tsukayama's scheme (early postoperative, late chronic, and acute hematogenous infections (EPI, LCI, AHI) and positive intraoperative cultures (PIC)). Non-hematogenous PJIs were also evaluated according to time since surgery: <1 month, 2-3 months, 4-12 months, >12 months. AHIs were mostly caused by Staphylococcus aureus (39.2%) and streptococci (30.2%). EPIs were characterized by a preponderance of virulent microorganisms (S. aureus, Gram-negative bacilli (GNB), enterococci), MDROs (24%) and polymicrobial infections (27.4%). Conversely, coagulase-negative staphylococci (CoNS) and Cutibacterium species were predominant in LCIs (54.5% and 6.1%, respectively) and PICs (57.1% and 15.1%). The percentage of MDROs isolated in EPIs was more than three times the percentage isolated in LCIs (7.8%) and more than twice the proportion found in AHI (10.9%). There was a significant decreasing linear trend over the four time intervals post-surgery for virulent microorganisms, MDROs, and polymicrobial infections, and a rising trend for CoNS, streptococci and Cutibacterium spp. The observed differences have important implications for the empirical antimicrobial treatment of PJIs. Benito N, Mur I, Ribera A, Soriano A, Rodriguez-Pardo D, Sorli L, et al. 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. 2019 May;8(5):673. 10.3390/jcm8050673 2077-0383 Journal of Clinical Medicine http://hdl.handle.net/20.500.13003/17153 31086080 L2002006706 2-s2.0-85069898523 https://hdl.handle.net/20.500.12105/22739 470992500108 Prosthetic joint infections Microbial etiology Classification schemes for prosthetic joint infections Antimicrobial empirical treatment Multidrug-resistant organisms 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