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https://www.readbyqxmd.com/read/29663554/implant-associated-bacterial-biofilm-and-quorum-sensing-in-periprosthetic-joint-infections
#1
Jake A Mooney, Eric M Pridgen, Robert Manasherob, Gina Suh, Helen E Blackwell, Annelise E Barron, Paul L Bollyky, Stuart B Goodman, Derek F Amanatullah
Periprosthetic joint infection (PJI) continues to be a common complication after total knee arthroplasty and total hip arthroplasty leading to severe morbidity and mortality. With an aging population and increasing prevalence of total joint replacement procedures, the burden of PJI will be felt not only by individual patients, but in increased healthcare costs. Current treatment of PJI is inadequate resulting in incredibly high failure rates. This is believed to be largely mediated by the presence of bacterial biofilms...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29660385/pre-operative-asymptomatic-bacteriuria-a-risk-factor-for-prosthetic-joint-infection
#2
R Weale, F El-Bakri, Kordo Saeed
BACKGROUND: Infection is a rare complication following implantation of prosthetic material into a joint. The impact of asymptomatic bacteriuria (ASB) before elective operations and the subsequent risk of prosthetic joint infection (PJI) are not well understood. AIMS: • Assess the prevalence of ASB amongst patients undergoing total arthroplasty of the hip and knee. • Determine the rates of PJI diagnosed within two years of the arthroplasty and if ASB is an independent risk factor for developing PJI...
April 13, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29656981/dual-agent-antibiotic-prophylaxis-using-a-single-preoperative-vancomycin-dose-effectively-reduces-prosthetic-joint-infection-rates-with-minimal-renal-toxicity-risk
#3
John R Burger, Benjamin J Hansen, Emily V Leary, Ajay Aggarwal, James A Keeney
BACKGROUND: We performed this study to compare prosthetic joint infection (PJI) and renal toxicity rates following hip and knee total joint arthroplasty (TJA) when a first-generation cephalosporin was administered either alone or in combination with a single preoperative vancomycin dose, whether vancomycin administration timing potentially influenced dual-antibiotic PJI prophylaxis approach effectiveness, and whether single-dose vancomycin use increased risk of renal impairment. METHODS: This was a retrospective study of 1977 consecutive primary TJAs (1871 patients) treated with cefazolin alone (1044 TJAs) or cefazolin with single-dose vancomycin (953 TJAs)...
March 14, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29656969/the-leukocyte-esterase-test-strip-is-a-poor-rule-out-test-for-periprosthetic-joint-infection
#4
Carl A Deirmengian, Lihua Liang, John P Rosenberger, Tony R Joaquim, Martin R Gould, Patrick A Citrano, Keith W Kardos
BACKGROUND: The urinary leukocyte esterase (LE) test strip has been suggested as a good screening test for periprosthetic joint infection (PJI). The purpose of this study is to compare the diagnostic profile of LE assays from different manufacturers and determine whether the LE test strip is a good rule-out test. METHODS: Synovial fluid samples (N = 344), sent to 1 laboratory for PJI testing, were used in this prospective study. Four different tests for synovial fluid LE were simultaneously evaluated for their performance in detecting white blood cell (WBC) positive samples (>3000 cells/µL)...
March 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29648630/identification-of-prosthetic-joint-infection-pathogens-using-a-shotgun-metagenomics-approach
#5
Matthew Thoendel, Patricio Jeraldo, Kerryl E Greenwood-Quaintance, Janet Yao, Nicholas Chia, Arlen D Hanssen, Matthew P Abdel, Robin Patel
Background: Metagenomic shotgun sequencing has the potential to change how many infections, particularly those caused by difficult to culture organisms, are diagnosed. Metagenomics was used to investigate prosthetic joint infections (PJIs), where pathogen detection can be challenging. Methods: 408 sonicate fluid samples generated from resected hip and knee arthroplasties were tested, including 213 from subjects with infections and 195 from subjects without infection...
April 10, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29643202/comparison-of-the-diagnostic-accuracy-of-periprosthetic-tissue-culture-in-blood-culture-bottles-to-prosthesis-sonication-fluid-culture-for-diagnosis-of-prosthetic-joint-infection-using-bayesian-latent-class-modeling-and-idsa-pji-criteria-for-classification
#6
Qun Yan, Melissa J Karau, Kerryl E Greenwood-Quaintance, Jayawant N Mandrekar, Douglas Osmon, Matthew P Abdel, Robin Patel
We have previously demonstrated that culturing periprosthetic tissue in blood culture bottles (BCBs) improves sensitivity compared to conventional agar and broth culture methods for diagnosis of prosthetic joint infection (PJI). We have also shown that prosthesis sonication culture improves sensitivity compared to periprosthetic tissue culture using conventional agar and broth methods. The purpose of this study was to compare the diagnostic accuracy of tissue culture in BCBs (subsequently referred to as tissue culture) to prostheses sonication culture (subsequently referred to as sonicate fluid culture)...
April 11, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29629935/corr-insights%C3%A2-what-markers-best-guide-the-timing-of-reimplantation-in-two-stage-exchange-arthroplasty-for-pji-a-systematic-review-and-meta-analysis
#7
Paul J Duwelius
No abstract text is available yet for this article.
April 6, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29629518/atypical-presentation-of-pneumocystis-jirovecii-infection-in-hiv-infected-patients-three-different-manifestations
#8
Bongyoung Kim, Jieun Kim, Seung Sam Paik, Hyunjoo Pai
Advances in the treatment and prevention of Pneumocystis jirovecii infection (PJI) in human immunodeficiency virus (HIV) patients decreased incidence and mortality dramatically, however, it may be associated with an increased frequency of unusual manifestation such as cystic formation, pneumothorax, focal infiltration, nodular formation, or extrapulmonary lesions. We report three cases of PJI with atypical manifestations. Each case demonstrates different clinical features: multiple nodular pulmonary lesion (32-year-old man with abnormal chest X-ray finding), subpleural mass-like lesion (43-year-old man with left visual loss and right pleuritic chest pain), and extrapulmonary mass-like lesions in the liver, lymph nodes, and small bowel (39-year-old man with cough, sputum, and dyspnea)...
April 9, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29628696/do-local-antibiotics-reduce-periprosthetic-joint-infections-a-retrospective-review-of-744-cases
#9
Craig Winkler, Joel Dennison, Adam Wooldridge, Eneko Larumbe, Cyrus Caroom, Mark Jenkins, George Brindley
Periprosthetic joint infections (PJI) are uncommon but not rare and have significant morbidity and financial implications. Local antibiotics have been used successfully in other areas of orthopedics to reduce postoperative infections, but this method has not been proven in total joint arthroplasty (TJA). Beginning January 1, 2014, our primary investigators began using surgical site lavage with providone-iodine solution and administering 2 g of vancomcyin powder in the surgical wound prior to capsule closure for all primary and revision total hip and knee arthroplasties...
March 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29627258/does-prior-failed-debridement-compromise-the-outcome-of-subsequent-two-stage-revision-done-for-periprosthetic-joint-infection-following-total-knee-arthroplasty
#10
Ashok Rajgopal, Inayat Panda, Arun Rao, Vivek Dahiya, Himanshu Gupta
BACKGROUND: There has been a debate regarding the outcomes of 2-stage revision total knee arthroplasty (TKA) when debridement, antibiotics, irrigation, and implant retention (DAIR) had been carried out previously. The purpose of this study is to evaluate the influence of prior failed DAIR (F-DAIR) on the outcomes of 2-stage revision TKA done for periprosthetic joint infection (PJI). METHODS: This is a retrospective study of a consecutive series of 184 knees that completed 2-stage revision TKA for PJI, operated by a single surgeon between January 2000 and July 2011...
March 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29623671/one-and-two-stage-surgical-revision-of-peri-prosthetic-joint-infection-of-the-hip-a-pooled-individual-participant-data-analysis-of-44-cohort-studies
#11
Setor K Kunutsor, Michael R Whitehouse, Ashley W Blom, Tim Board, Peter Kay, B Mike Wroblewski, Valérie Zeller, Szu-Yuan Chen, Pang-Hsin Hsieh, Bassam A Masri, Amir Herman, Jean-Yves Jenny, Ran Schwarzkopf, John-Paul Whittaker, Ben Burston, Ronald Huang, Camilo Restrepo, Javad Parvizi, Sergio Rudelli, Emerson Honda, David E Uip, Guillem Bori, Ernesto Muñoz-Mahamud, Elizabeth Darley, Alba Ribera, Elena Cañas, Javier Cabo, José Cordero-Ampuero, Maria Luisa Sorlí Redó, Simon Strange, Erik Lenguerrand, Rachael Gooberman-Hill, Jason Webb, Alasdair MacGowan, Paul Dieppe, Matthew Wilson, Andrew D Beswick
One-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators...
April 5, 2018: European Journal of Epidemiology
https://www.readbyqxmd.com/read/29619553/preoperative-pcr-analysis-of-synovial-fluid-has-limited-value-for-the-diagnosis-of-periprosthetic-joint-infections-of-total-knee-arthroplasties
#12
Bernd Fink, Markus Steurer, Sigrid Hofäcker, Peter Schäfer, Dieter Sandow, Philipp Schuster, Damian Oremek
Preoperative diagnosis of periprosthetic joint infection (PJI) is important because of the therapeutic consequences. This prospective study was designed to answer the question, if preoperative PCR analysis of the synovial fluid in addition to the culture and the CRP analysis of the blood are helpful for the diagnosis of PJI in knee arthroplasties. Before revision CRP analysis of the blood, cultivation and PCR analysis of synovial fluid of 116 knee endoprostheses were performed. During revision surgery, five tissue samples of the periprosthetic tissue were cultured and five further samples subjected to histological analysis...
April 4, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29614973/in-vitro-antibacterial-activity-of-bioactive-glass-s53p4-on-multiresistant-pathogens-causing-osteomyelitis-and-prosthetic-joint-infection
#13
Mateus Trinconi Cunha, Maria Aparecida Murça, Stanley Nigro, Giselle Burlamaqui Klautau, Mauro José Costa Salles
BACKGROUND: Conventional local treatment for medullary osteomyelitis (OM) includes insertion of antibiotic-loaded polymethylmethacrylate (PMMA) cement. Nevertheless, PMMA may delivery irregular concentration of antibiotic to surrounding tissue. We aimed to compare the in vitro antibacterial activity of Bioactive Glass (BAG) S53P4, which is a compound showing local antibacterial activity, to that of antibiotic-loaded PMMA against multidrug resistant bacteria from OM isolates. METHODS: We studied convenience samples of multidrug resistant (MDR) microorganisms obtained from patients presenting OM and prosthetic joint infection (PJI)...
April 3, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29610010/high-rate-of-positive-cultures-in-patients-referred-with-antibiotic-spacers-as-part-of-2-stage-exchange
#14
Kevin I Perry, Robert C Sproul, Rafael J Sierra, Matthew P Abdel, Thomas K Fehring, Arlen D Hanssen
BACKGROUND: Two-stage exchange for periprosthetic joint infection (PJI) in total knee arthroplasty (TKA) remains the gold standard treatment in North America. Occasionally, patients with knee PJI are referred for definitive management after resection and antibiotic spacer placement. Currently, little literature exists to suggest how these patients should be managed. The purpose of this study is to report the clinical outcomes of these patients. METHODS: We retrospectively identified 54 patients (54 knees) from 2000 to 2012 treated for PJI with initial TKA resection and spacer placement performed somewhere other than the definitive treatment center...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29609540/cost-benefit-analysis-of-antibiofilm-microbiological-techniques-for-peri-prosthetic-joint-infection-diagnosis
#15
Carlo L Romanò, Maria Teresa Trentinaglia, Elena De Vecchi, Nicola Logoluso, David A George, Ilaria Morelli, Lorenzo Drago
BACKGROUND: Implant-related infections, including those of peri-prosthetic joint (PJIs), osteosynthesis and other biomaterials, are biofilm-related. Pathogen identification is considered the diagnostic benchmark; however, the presence of bacterial biofilms makes pathogen detection with traditional microbiological techniques only partially effective. To improve microbiological diagnostic accuracy, some biofilm debonding techniques have been recently proposed. Aim of this health economics assessment study was to evaluate their economic impact on hospital costs...
April 2, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29605153/time-to-reimplantation-waiting-longer-confers-no-added-benefit
#16
Arash Aali Rezaie, Karan Goswami, Noam Shohat, Anthony T Tokarski, Alexander E White, Javad Parvizi
BACKGROUND: While the preferred surgical treatment for chronic periprosthetic joint infection (PJI) in North America is a 2-stage exchange arthroplasty, the optimal time between first-stage and reimplantation surgery remains unknown. This study was conceived to examine the association between time to reimplantation and treatment failure. METHODS: Using an institutional database, we identified PJI cases treated with 2-stage exchange arthroplasty between 2000 and 2016...
February 7, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29603341/antibiotic-loaded-calcium-sulfate-bead-and-pulse-lavage-eradicates-biofilms-on-metal-implant-materials-in-vitro
#17
Cory S Knecht, James P Moley, Mary S McGrath, Jeffrey F Granger, Paul Stoodley, Devendra H Dusane
Pulse lavage (PL) debridement and antibiotic loaded calcium sulfate beads (CS-B) are both used for the treatment of biofilm related periprosthetic joint infection (PJI). However, the efficacy of these alone and in combination for eradicating biofilm from orthopaedic metal implant surfaces is unclear. The purpose of the study was to understand the efficacy of PL and antibiotic loaded CS-B in eradicating bacterial biofilms on 316L stainless steel (SS) alone and in combination in vitro. Biofilms of bioluminescent strains of Pseudomonas aeruginosa Xen41 and a USA300 MRSA Staphylococcus aureus SAP231 were grown on SS coupons for 3 days...
March 30, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29601381/does-the-alpha-defensin-immunoassay-or-the-lateral-flow-test-have-better-diagnostic-value-for-periprosthetic-joint-infection-a-systematic-review
#18
Hannah K Eriksson, Jakob Nordström, Katja Gabrysch, Nils P Hailer, Stergios Lazarinis
BACKGROUND: Measuring alpha-defensin concentrations in synovial fluid may help to diagnose periprosthetic joint infection (PJI). There are two commercially available methods for measuring alpha-defensin in synovial fluid: the enzyme-linked immunosorbent assay-based Synovasure® alpha-defensin immunoassay, which gives a numeric readout within 24 hours, and the Synovasure lateral flow test, which gives a binary readout within 20 minutes. There is no compilation of the existing literature to support the use of one of these two tests over the other...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29599035/what-is-the-role-of-diagnostic-and-therapeutic-sonication-in-periprosthetic-joint-infections
#19
REVIEW
Rita Hameister, Chin T Lim, Christoph H Lohmann, Wilson Wang, Gurpal Singh
BACKGROUND: Periprosthetic joint infection (PJI) is one of the most dreaded complications in joint replacement surgery. Diagnosis and treatment can be difficult and biofilms are of major concern due to their low susceptibility toward antibiotics. METHODS: This review focuses on the use of sonication as an evolving diagnostic and adjunct treatment modality in the context of PJI. Therapeutic application of sonication is discussed separately for its (i) direct action on bacteria, (ii) synergistic effects with antibiotics, and (iii) effects on release of antibiotics from bone cement...
February 28, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29581070/diagnostic-accuracy-of-the-alpha-defensin-lateral-flow-device-synovasure%C3%A2-for-periprosthetic-infections-in-microbiologically-complex-situations-a-study-of-42-cases-in-a-french-referral-centre
#20
B de Saint Vincent, H Migaud, E Senneville, C Loiez, G Pasquier, J Girard, S Putman
BACKGROUND: Joint aspiration is currently the reference standard test for diagnosing periprosthetic joint infection (PJI) despite the high rate of false-negative results, of which a major cause is the fastidious nature of some micro-organisms. A rapid diagnostic test that detects alpha defensin (Synovasure™, Zimmer, Warsaw, IN, USA) in joint fluid can provide the diagnosis of PJI within a few minutes across the full spectrum of causative organisms (including mycobacteria and yeasts)...
March 23, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
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