213. ClinicalCcharacteristics and Prognosis of Candida Prosthetic Joint Infections
Session: Poster Abstract Session: Candida Infection
Thursday, October 8, 2015
Room: Poster Hall
Background:

Candida prosthetic joint infections are rare and its clinical characteristics and prognosis are still unclear. We retrospectively analyzed the clinical characteristics and prognosis of candida prosthetic joint infections.

Methods:

17 patients treated with candida prosthetic joint infections in 2 tertiary hospitals in South Korea between 2006 and 2013 were evaluated. 43 Patients with S.aureus prosthetic joint infections and 29 patients with S.epidermidis from the same hospitals were also evaluated.

This was a retrospective cohort study, with a follow-up of at least 1year and 6months or until the patient died.

Results:

Candida and S.epidermidis prosthetic joint infections showed lower level of serum C-reactive protein(CRP)(mg/dL) compared to S.aureus prosthetic joint infections significantly.(median 3.0 vs 3.0 vs 6.0, p=0.029) White blood cell(WBC)(mm3)count from joint fluid of candida prosthetic joint infections was also lower than S.aureus prosthetic joint infections.(median 4045 vs 65128, p=0.012) The relapse rate of candida prosthetic joint within the first 24weeks of follow-up was lower than S.aureus and S.epidermidis prosthetic joint infections.(6% vs 17% vs 29% p=0.085) Nonetheless, the relapse rate increased after 24 weeks. At the total follow up of 1year and 6months, the relapse rate of candida prosthetic joint infections was better than S.aures prosthetic joint infections but worse than S.epidermidis prosthetic joint infections.(35% vs 41% vs 17%, p=0.09)

Conclusion:

Serum CRP and joint fluid WBC may provide useful information in differentiating microorganism in prosthetic joint infections especially between candida and staphylococcal species. The relapse rate of the candida prosthetic joint infections was lower than staphylococcal prosthetic joint infections at a follow-up period of 24weeks. Howevere, the relapse rate increased after 24weeks. Therefore, long term follow-up should be considered for those with candida prosthetic joint infections.

 

Uh Jin Kim, MD1, Tae Hoon Oh, MD2, Ji Eun Kim, MD3, Hee Kyung Kim, MD4, Joon Hwan Ahn, MD5, Seung Ji Kang, MD4, Kyung Hwa Park, MD5, Sook in Jung, MD5, Jong Hee Shin, PHD6, Kyung Soon Park, PHD7, Jeong Geun Seon, PHD7 and Hee-Chang Jang, MD5, (1)Infectious Disease, Chonnam National University Hospital, Gwang Ju, South Korea, (2)Infectious Disease, Chonnam National University hospital, Gwang Ju, South Korea, (3)Chonnam National University Hospital, Gwang Ju, South Korea, (4)Chonnam National University Hwasun hospital, Hwasun-Gun, South Korea, (5)Chonnam National University Medical School, Gwangju, South Korea, (6)Laboratory Medicine, Chonnam National University Medical School, Gwang-ju, South Korea, (7)Orthopedic Surgery, Center for Joint Disease at Chonnam National University Hwasun Hospital, Hwasun-Gun, South Korea

Disclosures:

U. J. Kim, None

T. H. Oh, None

J. E. Kim, None

H. K. Kim, None

J. H. Ahn, None

S. J. Kang, None

K. H. Park, None

S. I. Jung, None

J. H. Shin, None

K. S. Park, None

J. G. Seon, None

H. C. Jang, None

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