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https://www.readbyqxmd.com/read/28419033/oral-only-linezolid-rifampin-is-highly-effective-compared-with-other-antibiotics-for-periprosthetic-joint-infection-study-of-a-mouse-model
#1
John M Thompson, Vikram Saini, Alyssa G Ashbaugh, Robert J Miller, Alvaro A Ordonez, Roger V Ortines, Yu Wang, Robert S Sterling, Sanjay K Jain, Lloyd S Miller
BACKGROUND: The medical treatment of periprosthetic joint infection (PJI) involves prolonged systemic antibiotic courses, often with suboptimal clinical outcomes including increased morbidity and health-care costs. Oral and intravenous monotherapies and combination antibiotic regimens were evaluated in a mouse model of methicillin-resistant Staphylococcus aureus (MRSA) PJI. METHODS: Oral linezolid with or without oral rifampin, intravenous vancomycin with oral rifampin, intravenous daptomycin or ceftaroline with or without oral rifampin, oral doxycycline, or sham treatment were administered at human-exposure doses for 6 weeks in a mouse model of PJI...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28407472/introduction-to-the-centers-for-disease-control-and-prevention-and-healthcare-infection-control-practices-advisory-committee-guideline-for-prevention-of-surgical-site-infection-prosthetic-joint-arthroplasty-section
#2
John Segreti, Javad Parvizi, Elie Berbari, Philip Ricks, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection...
April 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28403859/managing-uncertainty-a-qualitative-study-of-surgeons-decision-making-for-one-stage-and-two-stage-revision-surgery-for-prosthetic-hip-joint-infection
#3
Andrew J Moore, Ashley W Blom, Michael R Whitehouse, Rachael Gooberman-Hill
BACKGROUND: Approximately 88,000 primary hip replacements are performed in England and Wales each year. Around 1% go on to develop deep prosthetic joint infection. Between one-stage and two-stage revision arthroplasty best treatment options remain unclear. Our aims were to characterise consultant orthopaedic surgeons' decisions about performing either one-stage or two-stage revision surgery for patients with deep prosthetic infection (PJI) after hip arthroplasty, and to identify whether a randomised trial comparing one-stage with two-stage revision would be feasible...
April 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#4
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
April 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28390886/epidemiology-and-antibiotic-resistance-of-late-prosthetic-knee-and-hip-infections
#5
Lorenzo Drago, Elena De Vecchi, Monica Bortolin, Luigi Zagra, Carlo L Romanò, Laura Cappelletti
BACKGROUND: Prosthetic joint infections (PJI) are still a major complication of hip and knee arthroplasties. Identification of the causative pathogens and knowledge of their antibiotic susceptibilities are essential for the management of these infections. The main purpose of the study was to identify and compare the causative bacteria of prosthetic knee and hip joint infections in a reference Italian orthopedic center and to characterize antibiotic resistance profiles of bacteria involved...
March 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28389865/what-is-the-long-term-economic-societal-effect-of-periprosthetic-infections-after-tha-a-markov-analysis
#6
Thomas J Parisi, Joseph F Konopka, Hany S Bedair
BACKGROUND: Current estimates for the direct costs of a single episode of care for periprosthetic joint infection (PJI) after THA are approximately USD 100,000. These estimates do not account for the costs of failed treatments and do not include indirect costs such as lost wages. QUESTIONS/PURPOSES: The goal of this study was to estimate the long-term economic effect to society (direct and indirect costs) of a PJI after THA treated with contemporary standards of care in a hypothetical patient of working age (three scenarios, age 55, 60, and 65 years)...
April 7, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28385345/outcome-following-debridement-antibiotics-and-implant-retention-in-hip-periprosthetic-joint-infection-an-18-year-experience
#7
George Grammatopoulos, Benjamin Kendrick, Martin McNally, Nicholas A Athanasou, Bridget Atkins, Peter McLardy-Smith, Adrian Taylor, Roger Gundle
BACKGROUND: Debridement-antibiotics-and-implant-retention (DAIR) may be considered a suitable surgical option in periprosthetic joint infections (PJIs) with soundly fixed prostheses, despite chronicity. This study aims to define the long-term outcome following DAIR in hip PJI. METHODS: We reviewed all hip DAIRs performed between 1997 and 2013 (n = 122) to define long-term outcome and identify factors influencing it. Data recorded included patient demographics, medical history, type of DAIR performed (+/- exchange of modular components), and organisms identified...
March 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28379472/a-possible-novel-prosthetic-joint-infection-pathogen-mycoplasma-salivarium-identified-by-metagenomic-shotgun-sequencing
#8
Matthew Thoendel, Patricio Jeraldo, Kerryl E Greenwood-Quaintance, Nicholas Chia, Matthew P Abdel, James M Steckelberg, Douglas R Osmon, Robin Patel
Defining the microbial etiology of culture-negative prosthetic joint infection (PJI) can be challenging. Metagenomic shotgun sequencing is a new tool to identify organisms undetected by conventional methods. We present a case where metagenomics was used to identify Mycoplasma salivarium as a novel PJI pathogen in a hypogammaglobulinemic individual.
April 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28378243/prolonged-suppressive-antibiotic-therapy-for-prosthetic-joint-infection-in-the-elderly-a-national-multicentre-cohort-study
#9
V Prendki, T Ferry, P Sergent, E Oziol, E Forestier, T Fraisse, S Tounes, S Ansart, J Gaillat, S Bayle, O Ruyer, F Borlot, G Le Falher, B Simorre, F-A Dauchy, S Greffe, T Bauer, E N Bell, B Martha, M Martinot, M Froidure, M Buisson, A Waldner, X Lemaire, A Bosseray, M Maillet, V Charvet, A Barrelet, B Wyplosz, M Noaillon, E Denes, E Beretti, M Berlioz-Thibal, V Meyssonnier, E Fourniols, L Tliba, A Eden, M Jean, C Arvieux, K Guignery-Kadri, C Ronde-Oustau, Y Hansmann, A Belkacem, F Bouchand, G Gavazzi, F Herrmann, J Stirnemann, A Dinh
During prosthetic joint infection (PJI), optimal surgical management with exchange of the device is sometimes impossible, especially in the elderly population. Thus, prolonged suppressive antibiotic therapy (PSAT) is the only option to prevent acute sepsis, but little is known about this strategy. We aimed to describe the characteristics, outcome and tolerance of PSAT in elderly patients with PJI. We performed a national cross-sectional cohort study of patients >75 years old and treated with PSAT for PJI...
April 4, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28372916/oral-therapy-microbiological-findings-and-comorbidity-influence-the-outcome-of-prosthetic-joint-infections-undergoing-2-stage-exchange
#10
Tiziana Ascione, Pasquale Pagliano, Giovanni Balato, Massimo Mariconda, Renato Rotondo, Silvano Esposito
BACKGROUND: The aim of the present study was to investigate potential predictive factors of an unfavorable outcome in patients with prosthetic joint infection (PJI) undergoing 2-stage exchange. METHODS: Patients with PJI undergoing 2-stage exchange and observed over a 5-year period (2009-2013) were included. Cure was defined by the disappearance of infection after a 96-week follow-up period. Statistical analysis was performed using the Mann-Whitney U test, the Fisher exact test, and the multivariate analysis...
March 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28369296/the-not-so-good-prognosis-of-streptococcal-periprosthetic-joint-infection-managed-by-implant-retention-the-results-of-a-large-multicenter-study
#11
Jaime Lora-Tamayo, Éric Senneville, Alba Ribera, Louis Bernard, Michel Dupon, Valérie Zeller, Ho Kwong Li, Cédric Arvieux, Martin Clauss, Ilker Uçkay, Dace Vigante, Tristan Ferry, José Antonio Iribarren, Trisha N Peel, Parham Sendi, Nina Gorišek Miksic, Dolors Rodríguez-Pardo, María Dolores Del Toro, Marta Fernández-Sampedro, Ulrike Dapunt, Kaisa Huotari, Joshua S Davis, Julián Palomino, Danielle Neut, Benjamin M Clark, Thomas Gottlieb, Rihard Trebše, Alex Soriano, Alberto Bahamonde, Laura Guío, Alicia Rico, Mauro Jc Salles, M José G Pais, Natividad Benito, Melchor Riera, Lucía Gómez, Craig A Aboltins, Jaime Esteban, Juan Pablo Horcajada, Karina O'Connell, Matteo Ferrari, Gábor Skaliczki, Rafael San Juan, Javier Cobo, Mar Sánchez-Somolinos, Antonio Ramos, Efthymia Giannitsioti, Alfredo Jover-Sáenz, Josu Mirena Baraia-Etxaburu, José María Barbero, Peter F M Choong, Nathalie Asseray, Séverine Ansart, Gwenäel Le Moal, Werner Zimmerli, Javier Ariza
Background: Streptococci are not an infrequent cause of periprosthetic joint infection (PJI). Management by debridement, antibiotics, and implant retention (DAIR) is thought to produce a good prognosis, but little is known about the real likelihood of success. Methods: Retrospective, observational, multicenter, international study performed during 2003-2012. Eligible patients had a streptococcal PJI that was managed with DAIR. The primary endpoint was failure, defined as death related to infection, relapse/persistence of infection, or the need for salvage therapy...
March 23, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28343826/diagnosis-of-periprosthetic-joint-infection-an-algorithm-based-approach
#12
Nicholas T Ting, Craig J Della Valle
BACKGROUND: Periprosthetic joint infection (PJI) remains one of the most challenging and devastating modes of failure after total hip and knee arthroplasties. Despite the profound urgency and impact of PJI on an individual and societal basis, historically, there have not been standardized definitions of and diagnostic algorithms for infection after total joint arthroplasty. METHODS: In a recent symposium, the American Academy of Hip and Knee Surgeons put forth a standardized approach to the prevention, diagnosis, and management of the patient with a suspected PJI...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28339315/identification-of-asymptomatic-prosthetic-joint-infection-microbiologic-and-operative-treatment-outcomes
#13
Przemysław L Bereza, Alicja Ekiel, Aleksandra Auguściak-Duma, Małgorzata Aptekorz, Iwona Wilk, Piotr Wojciechowski, Damian J Kusz, Gayane Martirosian
BACKGROUND: This prospective study investigated the role of mechanical and biological factors in aseptic implant loosening or presumed silent prosthetic joint infection (PJI). METHODS: Thirty-seven patients were investigated. Microbiologic and molecular methods were used to detect bacteria on the surface of the failed implants removed during revision arthroplasty. Histopathologic analysis was performed. The influence of body mass index (BMI) and various co-morbidities on implant failure also was determined...
March 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28336247/surgical-case-order-has-an-effect-on-the-risk-of-subsequent-periprosthetic-joint-infection
#14
Antonia F Chen, Michael M Kheir, Joshua M Greenbaum, Camilo Restrepo, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) is a serious complication with multiple etiologies. Prior spine literature has shown that later cases in the day were more likely to develop surgical site infection. However, the effect of case order on PJI after TJA is unknown. This study aims to determine the influence of case order, prior infected case, and terminal cleaning on the risk for a subsequent PJI. METHODS: A retrospective, single-institution study was conducted on 31,499 TJAs performed from 2000 to 2014...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#15
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28326413/antibiotic-prophylaxis-for-dental-treatment-after-prosthetic-joint-replacement-exploring-the-orthopaedic-surgeon-s-opinion
#16
Clare M McNally, Renuka Visvanathan, Sharon Liberali, Robert J Adams
BACKGROUND: Antibiotic prophylaxis before dental treatment is routinely recommended by orthopaedic surgeons to prevent prosthetic joint infection (PJI). This recommendation is at odds with current guidelines. METHODS: A postal survey of 9 checkbox or short-answer questions was completed by 633 orthopaedic surgeons. RESULTS: The majority of respondents (n = 186 of 260, 72%) believe that antibiotic prophylaxis is required indefinitely for dental treatment...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#17
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Santos Martínez, Lluisa Sorlí, Juan P Horcajada, Joan C Monllau
BACKGROUND: Periprosthetic tissue cultures, sonication and synovial fluid cultures remain the gold standard for prosthetic joint infection (PJI) diagnosis. However, some 15-20% culture-negative PJI are still reported. Therefore, there is the need for other diagnostic criteria. One point of concern relative to the different definitions of PJI is as to the inclusion of the c-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as diagnostic criteria for PJI despite them being non-specific inflammatory blood tests...
March 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28318868/management-of-periprosthetic-joint-infection-the-more-we-learn-the-less-we-know
#18
Robert A Henderson, Matthew S Austin
BACKGROUND: Despite the tremendous and long-standing success of total hip arthroplasty and total knee arthroplasty as treatments for end-stage arthritis, periprosthetic joint infection (PJI) remains a rare but feared complication of these procedures. METHODS: This review highlights some of the difficulties inherent to studying PJI. These include the difficulty in powering studies to capture this relatively uncommon complication, as well as the heterogeneity in clinical presentation and manifestations associated with the diagnosis and treatment of PJI...
February 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318862/have-periprosthetic-hip-infection-rates-plateaued
#19
Dean C Perfetti, Matthew R Boylan, Qais Naziri, Carl B Paulino, Steven M Kurtz, Michael A Mont
BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Although the number of revision cases is increasing, the prevalence of PJI as an indication for revision surgery, and the variability of this indication among surgeons and hospitals, is unclear. METHODS: The New York Statewide Planning and Research Cooperative System was used to identify 33,582 patients undergoing revision THA between 2000 and 2013. PJI was identified using International Classification of Diseases, Ninth Revision diagnosis codes...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28316960/lower-urinary-tract-infection-and-periprosthetic-joint-infection-after-elective-primary-total-hip-arthroplasty
#20
Chan Ho Park, Young-Kyun Lee, Kyung-Hoi Koo
PURPOSE: Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is a grave complication. Urinary tract infection (UTI) as a source for PJI is controversial. Our purposes were, (1) to evaluate the incidence of PJI after elective primary THA and (2) to determine whether UTI was associated with a risk of PJI after elective primary THA. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 527 patients who underwent elective primary THA by using universal aseptic technique from May 2003 to October 2007...
March 2017: Hip & Pelvis
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