The major aerobic and facultative organisms isolated from prosthetic joint are staphylococci, streptococci and select aerobic Gram-negative bacteria. The predominate anaerobic organisms arePropionibacterium acnes, Clostridium spp. ( Clostridium perfringens, Clostridium difficile, Clostridium septicum and Clostridium cadaveris.), Peptostreptococcus spp. and Finegoldia magna, Actinomyces spp., Bacteroides spp.
P. acnes infection often presents late, occurring more than 3 months after the joint implantation, with some infections presenting beyond 36 months from the date of implantation; Clostridium infection tends to present early, within three months after the initial implantation of hardware ; Actinomyces spp. generally appear after a year of implantation.
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