Lack of Association of Interleukin-8 Gene Polymorphism with Helicobacter pylori-Induced Gastritis in Iranian Patients

from single centres have been published we present our experience with 15 cases over a 6-year period. Methods: The case notes of all patients with enterococcal PJI proved by culture of operative tissues received in 20022007 were reviewed, and their bacteriology, prophylaxis, treatment and outcomes assessed. Results: 15 patients (mean age 76 years) had enterococcal PJI of which 7 were related to hip hemiarthroplasty, 5 to knee replacement and 3 to hip replacement. All received cefuroxime prophylaxis and gentamicin cement at joint placement. 7 cases occurred in the 5 years 2002—2006 inclusive, and 8 cases in 2007. The mean time from joint placement to tissue diagnosis was 93 days; mean followup time from tissue diagnosis was 454 days. In 5 cases the infection was polymicrobial. 11 of the isolates (73%) were high-level resistant to gentamicin, compared to 31% of other enterococcal isolates. None were glycopeptide resistant. There were 3 successful 2-stage revisions (all knees), 1 successful conservative management with prosthesis retention (knee). Of the remaining patients, 4 remain on long term antibiotics (all hips), 4 have died (all within 100 days of tissue diagnosis) and 3 are still under active treatment. Conclusion: Enterococcal PJI has risen at our institution, and enterococci are now the commonest isolates from PJI. Current perioperative prophylaxis does not cover this organism adequately. Despite aggressive surgical and antibiotic treatment only 20% of patients had successful 2stage revisions, and 7% successful conservative management with prosthesis retention. Antibiotic treatments consisted of prolonged courses of amoxicillin or glycopeptide, but rarely gentamicin as most isolates manifested high-level resistance. Despite lengthy antibiotic courses and surgical intervention, enterococcal PJI has a poor prognosis.