Infections and prosthetic devices.

Hundreds of thousands of people have temporary or permanent prosthetic devices inserted each year in the United States. Infection rates associated with these devices vary depending upon numerous factors; however, overall, several percent of these devices become associated with infection. Diagnosis of these infections can be complicated by underlying disease, surgery, or the prosthesis itself, making it difficult to ascertain whether abnormalities of routine diagnostic studies are caused by infection. Specific diagnostic tests are usually required to confirm the presence of infection and identify the causative organism. The frequent isolation of skin organisms (such as Staphylococcus epidermidis) as the pathogen can also cause confusion as to whether the culture was contaminated. Fortunately, treatment of these infections is usually successful, although removal of the prosthetic device is often necessary. Recent laboratory and clinical studies that demonstrate various steps in the development of these infections and their response to treatment will help to better determine the optimal prevention, diagnosis, and treatment of these infections.