Features of diagnostics of biofilm (session) implant-associated infectious complications of knee arthroplasty
The features of the pathogenesis of paraprosthetic infectious complications associated with the leading role of session forms of pathogens determine the need to change methodological approaches to the diagnosis of periprosthetic infection. The results of microbiological examination of 357 samples of biological material obtained from 104 patients with implant-associated infection after primary knee replacement were analyzed. Among the pathogens of periprosthetic infection, the predominance of gram-positive cocci was noted (68,4%). The frequency of microbial associates in the etiological structure of implant-associated infection was 32,3-54,1%. The most informative methods of diagnosis of periprosthetic infection are methods associated with mechanical or ultrasonic destruction of biofilm. For rational etiotropic therapy of implant-associated infection, it is necessary to take into account the possible stimulation of biofilm formation with low doses of antibiotics and violation of the regime of antibiotic therapy, which contributes to the chronization of the infectious and inflammatory process.