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Advances in Orthopedics
Volume 2014 (2014), Article ID 580359, 7 pages
Research Article

Increasing Resistance of Coagulase-Negative Staphylococci in Total Hip Arthroplasty Infections: 278 THA-Revisions due to Infection Reported to the Norwegian Arthroplasty Register from 1993 to 2007

1Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
2Department of Clinical Science, University of Bergen, 5018 Bergen, Norway
3Department of Orthopaedic Surgery, Haukeland University Hospital, 5021 Bergen, Norway
4The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, 5021 Bergen, Norway
5Department of Clinical Medicine, University of Bergen, 5018 Bergen, Norway

Received 18 July 2014; Revised 25 September 2014; Accepted 25 September 2014; Published 9 October 2014

Academic Editor: Panagiotis Korovessis

Copyright © 2014 Olav Lutro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We investigated bacterial findings from intraoperative tissue samples taken during revision due to infection after total hip arthroplasty (THA). The aim was to investigate whether the susceptibility patterns changed during the period from 1993 through 2007. Reported revisions due to infection in the Norwegian Arthroplasty Register (NAR) were identified, and 10 representative hospitals in Norway were visited. All relevant information on patients reported to the NAR for a revision due to infection, including bacteriological findings, was collected from the medical records. A total of 278 revision surgeries with bacterial growth in more than 2 samples were identified and included. Differences between three 5-year time periods were tested by the chi-square test for linear trend. The most frequent isolates were coagulase-negative staphylococci (CoNS) (41%, 113/278) and Staphylococcus aureus (19%, 53/278). The proportion of CoNS resistant to the methicillin-group increased from 57% (16/28) in the first period, 1993–1997, to 84% (52/62) in the last period, 2003–2007 (P = 0.003). There was also significant increase in resistance for CoNS to cotrimoxazole, quinolones, clindamycin, and macrolides. All S. aureus isolates were sensitive to both the methicillin-group and the aminoglycosides. For the other bacteria identified no changes in susceptibility patterns were found.