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National infection control program has no effect on postoperative infections after total hip arthroplasty
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Orthopedics.
Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Swedish Hip Arthroplasty Register, Centre of Registers, Västra Götalandsregionen, Gothenburg.
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Orthopedics.
Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm.
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(engelsk)Manuskript (preprint) (Annet vitenskapelig)
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Identifikatorer
URN: urn:nbn:se:oru:diva-94137OAI: oai:DiVA.org:oru-94137DiVA, id: diva2:1591672
Tilgjengelig fra: 2021-09-07 Laget: 2021-09-07 Sist oppdatert: 2021-09-28bibliografisk kontrollert
Inngår i avhandling
1. Prosthetic Joint Infection of the Hip: Cause and Effect
Åpne denne publikasjonen i ny fane eller vindu >>Prosthetic Joint Infection of the Hip: Cause and Effect
2021 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Every year, 18 000 patients in Sweden and more than 1 million worldwide undergo total hip arthroplasty (THA). The operation is of great benefit to patients, but is associated with several complications. Prosthetic joint infections (PJIs) are among the most common complications, and can be devastating in terms of suffering for the patient and cost for the healthcare provider. The aim of this thesis was to investigate different aspects of PJIs in order to gain a better understanding of the causes and effects of infection. 

Four studies were conducted covering genomic analysis of the causative organism, identification of risk factors for failure of treatment, evaluation of a national infection control program aimed at reducing the burden of infections (PRISS: Prosthesis-related infections shall be stopped), and examination of the long-term impact of a PJI on the patient’s health through patient-reported measurement questionnaires.

The main findings were as follows. Commensal bacteria such as Cutibacterium avidum have the potential to cause PJIs, and should be specially accounted for when performing hip surgery with an anterior approach. S. aureus is both a commensal and a pathogen with invasive capacity, and the commensal strains do not differ from the PJI strains regarding prevalence of virulence genes and clonal complexes. The genomic traits of pathogens had no impact on treatment success or eradication of infection in S. aureus PJIs The long-term effects of a PJI in the hip include increased mortality, lower quality of life, and decreased hip function. The incidence of PJIs was higher following the PRISS project. Increasing risk factors contributing to PJI explain the increasing incidence of PJI after primary THA.

In conclusion, PJIs of the hip have multifactorial causes which are difficult to reduce, and long-term effects are severe.

sted, utgiver, år, opplag, sider
Örebro: Örebro University, 2021. s. 98
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 246
Emneord
Prosthetic joint infection, infection, arthroplasty, hip, Staphylococcus aureus, Cutibacterium avidum, hip, outcome, PROM
HSV kategori
Identifikatorer
urn:nbn:se:oru:diva-92269 (URN)978-91-7529-398-1 (ISBN)
Disputas
2021-10-01, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (svensk)
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Veileder
Tilgjengelig fra: 2021-06-09 Laget: 2021-06-09 Sist oppdatert: 2023-08-29bibliografisk kontrollert

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