Prosthetic joint infection of the hip and knee due to Mycobacterium species: A systematic review

Table 1 Articles included in the systematic review

No	Ref.	Joint involvement (No. of cases)	Pathogens	Onset of disease (early: ≤ 3 mo; late: > 3 mo)	Treatment	Outcome
1	Ribeiro et al[7], 2020	Hip (1)	M. tuberculosis	Early	Removal of prosthesis	Controlled
2	Patel et al[8], 2019	Hip (1)	M. bovis	Late	Removal of prosthesis	Controlled
3	Sixt et al[9], 2020	Hip (1)	M. avium	Late	Removal of prosthesis	Controlled
4	Barry et al[10], 2019	Knee (1)	M. tuberculosis	Late	Antimicrobials only	Controlled
5	Goldstein et al[11], 2019	Hip (2), knee (4)	M. intracellulare (1), M. abscessus (1), M. fortuitum (1), M. gordonae (1), NA (2)	Early (1), kate (4), NA (1)	Removal prosthesis (5), amputation (1)	Controlled
6	Buser et al[12], 2019	Hip (5), knee (4)	M. fortuitum (7), M. goodii (2)	Early (1), late (8)	NA	NA
7	Spanyer et al[13], 2018	Knee (1)	M. abscesus	NA	Removal of prosthesis	Controlled
8	Meyssonnier et al[14], 2019	Hip (9)	M. tuberculosis (9)	Late (5), intraoperative (4)	Antimicrobials only (5), removal of prosthesis (4)	Controlled
9	Chang et al[15], 2018	Hip (7), knee (6)	M. tuberculosis (13), mixed infection (6)	Early (2), late (11)	Removal of prosthesis (11), debridement (2)	Controlled (8), persistent (3), dead (2)
10	Metayer et al[16], 2018	Hip (1)	M. bovis	Late	Removal of prosthesis	Controlled
11	Elzein et al[5], 2017	Knee (1)	M. tuberculosis	Late	Removal of prosthesis	Controlled
12	Kim et al[17], 2017	Knee (2)	M. abscessus	Early (1), late (1)	Removal of prosthesis (2)	Controlled
13	Henry et al[18], 2016	Hip (1), knee (1)	M. abscessus	Late	Removal of prosthesis (2)	Controlled
14	Jeong et al[19], 2012	Knee (1)	M. wolinskyi	NA	Debridement	NA
15	Lee et al[20], 2012	Knee (1)	M. chelonae	Late	Removal of prosthesis	Controlled
16	Wang et al[21], 2011	Knee (1)	M. abscessus, M. fortuitum	Early	Removal of prosthesis	NA
17	Ahmad et al[22], 2010	Knee (1)	M. goodii	Early	Removal of prosthesis	Controlled
18	Gupta et al[23], 2009	Hip (1)	M. avium complex	Late	Removal of prosthesis	Controlled
19	Porat et al[24], 2008	Knee (2) bilateral	M. fortuitum	Late	Antimicrobials only	Persistent
20	Reigstad et al[25], 2008	Hip (1)	M. bovis	Late	Removal of prosthesis	Controlled
21	Brown et al[26], 2008	Hip (1)	M. tuberculosis, M. chelonae	Late	Removal of prosthesis	Controlled
22	Cheung et al[27], 2008	Knee (1)	M. fortuitum	Early	Removal of prosthesis	Controlled
23	Eid et al[28], 2007	Knee (7), hip (1)	M. chelonae (3), M. abscessus (2), M. fortuitum (3), M. smegmatis (1)	Early (3), late (5)	Removal of prosthesis	Controlled (7), persistent (1)
24	Segal et al[29], 2007	Hip (1)	M. bovis	Late	Removal of prosthesis	Controlled
25	Khater et al[30], 2007	Knee (1)	M. tuberculosis	Early	Removal of prosthesis	Controlled
26	Pulcini et al[31], 2006	Hip (1)	M. wolinskyi	Late	Removal of prosthesis	Controlled
27	Neuberger et al[32], 2006	Knee (1)	M. kansasii	Late	Removal of prosthesis	Controlled
28	Wong et al[33], 2005	Hip (1)	M. farcinogenes	Late	Removal of prosthesis	Controlled
29	Yim et al[34], 2004	Hip (10)	M. xenopi	Late	Removal of prosthesis	Controlled
30	Spinner et al[35], 1996	Knee (1)	M. tuberculosis	Early	Debridement	Controlled
31	Pring et al[36], 1996	Knee (1)	M. chelonae	Early	Removal of prosthesis	Controlled
32	Kreder et al[37], 1996	Hip (1)	M. tuberculosis	Late	Removal of prosthesis	Controlled
33	Lusk et al[38], 1995	Knee (1)	M. tuberculosis	Late	Removal of prosthesis	Dead
34	Tokumoto et al[39], 1995	Knee (2), hip (1)	M. tuberculosis	Late	Removal of prosthesis (3)	Controlled
35	Ueng et al[40], 1995	Hip (2)	M. tuberculosis	Late	Removal of prosthesis (2)	Controlled
36	Heathcock et al[41], 1994	Hip (1)	M. chelonae	Late	Removal of prosthesis	Controlled
37	Leach et al[42], 1993	Hip (1)	M. bovis	Late	Removal of prosthesis	Controlled
38	Guerra et al[43], 1998	Hip (1)	M. bovis	Late	Removal of prosthesis	Controlled
39	LaBombardi et al[44], 2005	Knee (1)	M. thermoresistibile	Early	Removal of prosthesis	Controlled
40	Saccente[45], 2006	Knee (1)	M. fortuitum	Early	Removal of prosthesis	Controlled
41	Wang et al[46], 2007	Knee (1)	M. tuberculosis	Late	Debridement	Dead
42	Klein et al[47], 2012	Knee (1)	M. tuberculosis	Late	Removal of prosthesis	Controlled
43	Srivastava et al[48], 2011	Hip (1)	M. bovis	Late	Removal of prosthesis	Controlled
44	Rispler et al[49], 2015	Knee (1)	M. bovis	Late	Debridement	Controlled
45	Vutescu and Koenig[50], 2017	Knee (1)	M. cosmeticum	Late	Removal of prosthesis	Controlled
46	Jitmuang et al[4], 2017	Knee (10), hip (1)	M. fortuitum (9), M. abscessus (1), M. peregrinum (1) (mixed cases 2)	Early (9), late (2)	Removal of prosthesis (10), debridement (1)	Controlled (6), persistent (1), NA (4)
47	Mannelli et al[51], 2018	Hip (1)	M. chelonae	Late	Antimicrobials only	Persistent
48	Uhel et al[52], 2019	Hip (6), knee (6)	M. tuberculosis	Late (12)	Antimicrobials only (4), removal of prosthesis (5), debridement (3)	Controlled (8), persistent (3), dead (1)
49	Rodari et al[53], 2020	Hip (1)	M. xenopi	Late	Removal prosthesis	Controlled
50	Congia et al[54], 2020	Knee (1)	M. tuberculosis	Early	Debridement	Controlled
51	Fix et al[55], 2020	Hip (1)	M. fortuitum	Early	Removal prosthesis	Controlled

Removal of prosthesis: With or without revision. M.: Mycobacteria; NA: Not available.

Table 2 Descriptive comparison between tuberculous and nontuberculous Mycobacteria prosthetic joint infection cases (excluding mixed-infection cases)

	Tuberculous PJI (n = 43)	Nontuberculous PJI (n = 63)	P value
Joint involvement
Hip	22/43 (55.1%)	22/63 (34.9%)	0.096
Knee	21/43 (44.9%)	41/63 (65.1%)
Onset of disease after index surgery
≤ 3 mo	5/43 (11.6%)	22/60 (36.7%)	0.002
> 3 mo	34/43 (79.1%)	38/60 (63.3%)
Intraoperative	4/43 (9.3%)	0
NA	0	3
Treatment
Antimicrobial therapy only	10/43 (23.3%)	2/54 (3.7%)	0.002
Debridement	8 /43(18.6%)	3/54 (5.5%)
Removal of prosthesis	25/43 (58.1%)	48/54 (88.9%)
Amputation	0	1/54 (1.8%)
NA	0	9
Outcome
Infection controlled	35/43 (81.4%)	44/48 (91.7%)	0.092
Persistent infection	4/43 (9.3%)	4/48 (8.3%)
Dead	4/43 (9.3%)	0
NA	0	15

P < 0.05: Significant. NA: Data not available; PJI: Prosthetic joint infection.