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• W2978076492 abstract "Purpose: The risk of prosthetic joint infection (PJI) after gastrointestinal endoscopic procedures has not been evaluated in large, prospective studies. The purpose of this study was to determine whether there is an association between prosthetic hip or knee infections and gastrointestinal endoscopic procedures. Methods: We conducted a prospective, single center, case-control study at a tertiary care referral center. Cases were defined as adults hospitalized for PJI of the hip or knee from December 1, 2001 through May 31, 2006. Controls were adults with hip or knee arthroplasties without a diagnosis of infection admitted during the same study period. Associations between gastrointestinal endoscopic procedures (esophagogastroduodenoscopy [EGD], colonoscopy, or flexible sigmoidoscopy, all with or without biopsy) performed within 2 years prior to admission or after arthroplasty that was less than two years prior to admission and PJI were assessed using logistic regression and results were reported as odds ratio (OR) and 95% confidence intervals. Results: A total of 339 cases and 339 controls were included in the study. One percent of each cohort received prophylactic antibiotics prior to endoscopy. In the preceding two years prior to admission, 70 (20.6%) of cases and 82 (24.2%) of controls had undergone a gastrointestinal endoscopic procedure (OR 0.8, 95%CI 0.6-1.2, P=0.31). However, EGD with biopsy was associated with an increased risk of PJI (OR 2.5, 95%CI 1.1-5.7, P=0.035). In a multivariate analysis adjusting for gender, age, joint age, immunosuppression, BMI, presence of wound drain, prior arthroplasty, malignancy, ASA score and prothrombin time, the OR for infection after EGD with biopsy was 3.8 (95%CI 1.5-9.6, P=0.004). The two most common organisms associated with PJI were Staphylococcus aureus (29.7%) and coagulase negative Staphylococcus (28.6%). Prior endoscopy, however, did not influence the microbiology of PJI, as a similar pathogen distribution was demonstrated in the cohort who developed PJI but did not undergo endoscopy. No patients in this cohort underwent esophageal sclerotherapy or laser therapy, procedures associated with the highest incidence of bacteremia. Conclusion: In patients with prosthetic joints, EGD with biopsy was associated with an increased risk of PJI. To our knowledge, this association has not been previously reported and is not reflected in the current guidelines which recommend that prophylactic antibiotics are not needed in patients with prosthetic joints prior to undergoing endoscopy. Further studies are needed to confirm this association and to evaluate the role, if any, of antibiotic prophylaxis in this setting." @default.
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• W2978076492 date "2009-10-01" @default.
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• W2978076492 title "Are Gastrointestinal Endoscopic Procedures Associated with an Increased Risk of Prosthetic Joint Infection (PJI)?" @default.
• W2978076492 doi "https://doi.org/10.14309/00000434-200910003-01387" @default.
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