Successful Management of Achromobacter-Associated Periprosthetic Joint Infections After Total Knee Arthroplasty: A Case Series of Ten Knees in Six Patients
Abstract
Background: Periprosthetic joint infections (PJIs) following total knee arthroplasty (TKA) are often caused by common pathogens; however, rare organisms like Achromobacter species pose unique diagnostic and therapeutic challenges. This case series evaluates 10 Achromobacter-related PJIs among 6 patients.
Methods: A prospective single-center case series of patients aged greater than 18 years with culture-confirmed Achromobacter PJI was conducted at a New Delhi tertiary care center beginning July 2023. Diagnosis was established using European Bone and Joint Infection Society criteria. Data collection included demographic details, comorbidities, diagnostics, microbiology, surgical interventions, and outcomes. Management was individualized based on infection severity and patient factors.
Results: Five female and 1 male patient [mean age: 61.83 years] presented with ten infected TKAs. Four developed bilateral infections. Most patients presented with sinus tracts; 2 immunocompetent patients had an indolent course. Diagnosis was confirmed using automated continuously monitored blood culture system (n = 3), conventional culture (n = 2), and matrix-assisted laser desorption/ionization time-of-flight (n = 1). Four patients (6 knees) had Achromobacter xylosoxidans, 2 patients (4 knees) had Achromobacter denitrificans. One patient with initial bilateral A xylosoxidans infection developed reinfection with the A denitrificans strain in the left knee. Five patient had significant…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 6 participants or records.
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