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BMJ. 1994 Aug 20-27;309(6953):506-8.

Relation between mouth and haematogenous infection in total joint replacements.

Author information

1
Wirral Hospital NHS Trust, Wirral, Merseyside.

Abstract

OBJECTIVE:

To investigate the source of infections associated with orthopaedic prostheses.

DESIGN:

Analysis of four infections of prosthetic joints with case records; minimum inhibitory and minimum bactericidal concentrations and sodium dodecylsulphate polyacrylamide gel electrophoresis of the cell wall polypeptides of the Streptococcus sanguis isolates from the mouth and infected prostheses; examination of the patients' mouths for periodontal disease and caries.

SUBJECTS:

Four adults (three men) aged 58-83.

RESULTS:

For each patient the strain of S sanguis isolated from the mouth was indistinguishable from that isolated from the prosthesis. All patients had severe periodontal disease and caries.

CONCLUSIONS:

The mouth was probably the source of bacterial infection in the prosthetic joints of these patients; the route of infection was possibly haematogenous. Incipient oral infection should be treated before joint replacement, and oral health should be maintained indefinitely.

PMID:
8086903
PMCID:
PMC2542714
[Indexed for MEDLINE]
Free PMC Article

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