Incidence, associated burden of disease, and healthcare utilisation of prosthetic joint infections due to Staphylococcus aureus in European hospitals. The COMBACTE-NET ARTHR-IS multicentre study.

BACKGROUND: This study aims to estimate the incidence, associated burden of disease and healthcare utilisation due to Staphylococcus aureus prosthetic joint infections (SA-PJI) after a primary hip and knee arthroplasty in European centres.

METHODS: This study was performed on patients who underwent a primary hip and knee arthroplasty at 19 European hospitals from 2014 to 2016. Global incidence of PJI and SA-PJI was calculated. Associated burden of disease was measured indirectly as infection-related mortality plus loss of function. For healthcare utilisation, number and duration of hospitalizations, number and type of surgical procedures, duration of antibiotic treatments, and number of outpatient visits were collected. Subgroup and regression analysis were used to evaluate the impact of SA-PJI healthcare utilisation controlling for confounding variables.

RESULTS: Incidence of PJI caused by any microorganism was 1.41% and 0.40% for SA-PJI. Among the SA-PJI, 20.7% were due to MRSA with substantial regional differences and more frequent in PHP. Related death and loss of function occurred in 7.0% and 10.2% of SA-PJI respectively and was higher in patients with PHP. Compared with patients without PJI, patients with SA-PJI had a mean difference of 1.4 more readmissions, 25.1 more days of hospitalization, underwent 1.8 more surgical procedures, and had 5.4 more outpatient visits, controlling for confounding variables. The healthcare utilisation was higher in patients who failed after surgical treatment to SA-PJI.

CONCLUSIONS: This study confirms that the burden of SA-PJI is high specially in PHP and provides a solid basis for planning interventions to prevent SA-PJI.