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Susceptibility testing of isolates was performed according to CLSI (NCCLS) guidelines. The MicroScan WalkAway (Dade Behring Inc., Deerfield, IL, USA) and agar dilution methods were used for isolates from 1998 to 1999 and the Vitek-2 (bioMerieux, Marcy l��Etoile, France) was used for isolates from 2000 until 2007. The Kaplan�CMeier method was used to estimate the 2-year survival rate free of treatment failure. A Fisher exact test was used for analysing categorical data. Over the study period 1919 total knee replacement and 1912 total hip replacement operations Selleck LY2109761 were performed at this institution. Ninety patients were identified as having a prosthetic knee (41) or hip (49) joint infection and of these 21 (23%) involved a Gram-negative bacillus. Gram-negative PJI were more likely to involve a hip prosthesis than a knee (17 vs 4; p?0.006). Four of the patients with Gram-negative infections were excluded from further examination in this study because they underwent either prosthesis removal (two patients) or exchange (two patients) as the primary surgical treatment. All four of these patients had a ��late�� PJI, with a median joint age of 38?months at the time of surgical intervention. The remaining 17 patients met the inclusion criteria and formed Oxacillin the study population. Characteristics of individual patients and their outcomes can be seen in Table?1. The median age was 75?years (range 65�C91?years). Fifteen patients had a hip PJI and two patients had a knee PJI. The original indication for joint replacement surgery was osteoarthritis in 14 patients, aseptic loosening of a previous prosthesis in two patients and avascular necrosis of the femoral head in one patient. Four patients had a fully cemented prosthesis, two had a non-cemented prosthesis and 11 had a cemented femoral stem/non-cemented acetabular cup hip prosthesis. Two patients were immunosuppressed, two had malignancies, EPZ5676 chemical structure two had chronic renal failure, two had type 2 diabetes mellitus and one had rheumatoid arthritis. The median duration from prosthesis insertion until first debridement (joint age) was 17?days (range 9�C1435). The median duration of symptoms until debridement was 7?days (range 1�C19). The median time from diagnosis of infection until debridement was