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Knee Infection* Serratia marcescens

Clocacola

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Hi All, I've been reading some threads, so I thought I would post. I've had 2 THR (r 12/2014, L 10/2017) right TKR (3/2015)

Three weeks after my left hip, my incision started gushing and then developed blisters. Was on oral antibiotics and ended having debriment revision surgery 12/2017.

I was found to have serratia marcescens infection.completed 6 WKS IV antibiotic treatment and was free of infection after they were completed. Fast forward to Sept. 20/19 cripplin pain in rt. Hip sent me to ER and same infection was found, another debriment revision and 6 wk. IV antibiotic, was cleared again after finishing.

11/2019 crippling pain in rt knee..same infection, debriment revision 6 wks zosyn. Got my port out in Feb.

In April I had trouble above my knee..took oral antibiotics for that and by the time dr. Said he needed to do a debriment. .it looked like a nasty pus filled tennis ball was coming out adove my knee. So I just got home from debriment. .he found no infection around my hardware. I had a week of zosyn in hospital and am on oral antibiotics sulfameth trimethoprim for 14 days. I haven't been able to find out much about serratia infections. Just that they are antibiotic resistance gram negative infections that are rare. Just curious if anyone else has had it, or what you all might know! Thanks
 
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Jaycey

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@Clocacola Welcome to BoneSmart! We have many members who have been through the infection journey. But I really can't say I have seen a member here with your specific infection.

Is the same surgeon treating you in every instance? Is an infectious disease specialist involved in your treatment? Yes this infection is very tough to eliminate. But a specialist in infection control might offer a better long term solution.
 
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Clocacola

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Hi Jaycey, thanks for the reply. Yes, same surgeon has been treating me for all infections. He is working with an infectious disease specialist, but I haven't personally seen one.
 

Pumpkln

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Clocacola,
Have you sought a second opinion for your infection?
Having a set of new eyes on your replacements and infections may give you more options for treatments available to you.

You can use the Surgeon Locator at the top of the page for your search, you will want to look for someone specializing in revisions and/or complex joint reconstruction. They are the surgeons who have the most education and experience with troubled joints.
 

Celle

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@Clocacola - I'm sorry to read you've had all these joint infections. It must be wearying and worrying for you. :console2:

I've read that serratia marcescens can be resistant to many antibiotics and it sounds to me as if it has never been properly eliminated from your body.
You say that an Infectious Disease doctor has been consulting with your surgeon. I think it's time for you to ask to talk to him/her as well.

There are several questions that I think should be asked and answered:
  1. Were swabs sent for culture and antibiotic sensitivities after each joint infection was diagnosed?
  2. Did these swabs show that the infection was sensitive to Zosyn each time?
  3. Were further tests sent after you had completed a course of Zosyn, and did those cultures show no infection present?
  4. Has long-term antibiotic therapy been considered? It's quite common to do this after an artificial joint infection.
 
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Clocacola

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I know that initially swabs have been cultered. I do not know for sure about 2,3 and 4. Very good questions to ask my surgeon. I sure appreciate it, as he is always in a rush to just reassure me I think we got it. I didn't have a single blood draw in my 7 day hospital stay. My experiences here in Mississippi, have paled to my Ohio and Fl. healthcare. Anyway, I'll be sure and ask next time I see him for staple removal. Thank you so much!
 

sistersinhim

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It'd probably be a good idea to write a list of all your questions for your doctor. If you're like me, you'll forget half of the questions when you get to see him without a list.
 
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Clocacola

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Hello again, I've just had to have another revision surgery for infection in my knee. This time it is the 2 stage revision. I had an appointment with a specialist but, was unable to see him as it happened so quick. I'm on another round of IV antibiotics and of course on a walker for the non weight bearing spacer. I'm so tired of all of this. Just wanted to check in and maybe find someone else that might be having the same troubles.
 

sistersinhim

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I hate to hear that you have to be going through all this. Just know that you are not alone and there will always be someone hear to listen. :flwrysmile: :console2:
 

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_Annie_

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@Clocacola
Annie here. I have an infection in a stitch and cellulitis. I was put on an antibiotic (Doxycycline) for a week. I think, and my PT agrees, that I am much improved from last week. I am changing out an antibacterial Silver wound care Pad, daily on top of the stitch then cover with a bandage. I also let it air out for 1 hour/day. The stitch is about half the depth of what it initially was. It’s hard to see that in the picture. The cellulitis isn’t as red or raised as it was initially. I have not had a culture taken to determine what kind of infection I have. I see my OS on Thursday of this week. Will report back after the Dr visit.

A3236E41-ABB0-4BAC-9890-95C9161AA905.jpeg E173215B-6DEA-4804-AFB8-FFCC42C4DFD4.jpeg
 

Celle

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Hello again, I've just had to have another revision surgery for infection in my knee. This time it is the 2 stage revision. I had an appointment with a specialist but, was unable to see him as it happened so quick. I'm on another round of IV antibiotics and of course on a walker for the non weight bearing spacer.
Hello again @Clocacola - I'm so sorry to hear that you have to go through all this again. :console2:
Please will you tells the date you had this latest surgery, so we cn add that to your signature?

I'm just hoping that doing the two-stage revision - removing all the hardware and fitting you with an antibiotic spacer - will be the charm that cures your infection completely.

I trust that samples were taken and your Infection Treatment doctor has recommended the most suitable antibiotic to treat the infection.

Before your antibiotic spacer is removed and you're given a completely new s of hardware, knee aspiration samples and blood tests will need to show that there are no signs at all of lingering infection.

@PegGar16 had a lengthy battle to cure the infection in her knee, but she's all right now. I'm going to ask he if she'll come and talk to you.
 

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Hi @Clocacola! I just read what you have be going through. 3 infected joints!!!!. (Have my prayers going your way) What kind of specialist did they have you set up with? I truly believe you need to get a copy of your records and find a Infectious Disease Doctor, not the one that your OS is using. Maybe your primary care doctor can help with a referral. You need an ID to look at the whole picture and explain it to you.....not just when can they put in the new knee. You need to find out what is going on with this Serratia Marcescens. For it to have gotten to all of your prosthetic joints is scary. Why does it keep coming back when the surgeon says it gone?
I had to deal with multiple surgeries and grafts due to staph epi. I know you must be so frustrated with this. One surgery after another, after another....It seemed that every time I felt better from 1 procedure it was time for another..grrrrr. I am not a medical professional or anything but I would want to know about the infection and what to expect ASAP. I feel you would get better info from a new ID.
There is always someone here to chat if you need to...or even vent.
 

DSJ

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Im also going through a 2 stage revision. It's considered to be the " gold standard" for infected implants.
My surgeon used a regular knee implant with antibiotic infused glue rather than a cement spacer.
Maybe its because I'm in Canada and costs are not an issue. It's expected to last for up to five years.

Its easy to get depressed, but just remember that there are things that you can
control ane things you cant. Work on what you can and don't let the rest stress you.
 

newlybionic

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You need to have an Infectious Disease(ID) doctor that you can talk to. I had an infection and when I went back to the hospital I saw an ID doctor every day I was in the hospital. After discharge I continued to see her. I had a PICC line and had IV antibiotics for 6 weeks and oral antibiotics for an additional 4 months. I had swabs from my knee to show the infection and what antibiotic can be used to eradicate it. I had follow up blood work to check to see if the infection had cleared. My OS did the surgery but the ID handled the antibiotics.
 
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Clocacola

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Hello! Thanks for the advise, I really appreciate it. I initially had the same infection in my hip..2 wks after replacement..then 1 yr later again in hip..now with this knee..it's been a trying time for sure. Glad to know I'm not alone in my plight. I had a phone interview with infectious disease dr, whom my surgeon has been consulting with. My culture's after surgery have shone no bacteria present, so that is good. I will eventually see him in person, but good to know about my blood work/culture's. I see my ortho on the 8th with blood work b4 of course. Thanks again for the replies, my hardware was removed 8/25 so in halfway through my IV antibiotics!
 

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