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Joint AND infection

Timothy L Tan, Karan Goswami, Yale A Fillingham, Noam Shohat, Alexander J Rondon, Javad Parvizi
BACKGROUND: Two-stage exchange arthroplasty remains the preferred surgical treatment method for patients with chronic periprosthetic joint infection (PJI). The success of this procedure is not known exactly as various definitions of success have been used. This study aimed at analyzing the difference in outcome following 2-stage exchange arthroplasty using different definitions for success. METHODS: A retrospective study of 703 patients with PJI who underwent resection arthroplasty and spacer insertion between January 1999 and June 2015 was performed...
June 20, 2018: Journal of Arthroplasty
Rahul Goel, Patrick Buckley, Emily Sterbis, Javad Parvizi
BACKGROUND: Two-stage exchange arthroplasty is the preferred treatment for chronic periprosthetic joint infection following total hip arthroplasty (THA). These patients are at high risk of substantial blood loss and perioperative blood transfusion. Our study aimed at determining risk factors for blood transfusion during a 2-stage exchange for infected THA. METHODS: Medical records of 297 patients with infected THA who underwent 2-stage exchange arthroplasty from 1997 to 2016 were reviewed...
July 2, 2018: Journal of Arthroplasty
Noam Shohat, Karan Goswami, Yale Fillingham, Timothy L Tan, Tyler Calkins, Craig J Della Valle, Jaiben George, Carlos Higuera, Javad Parvizi
BACKGROUND: Despite concern over the interpretation of serum and synovial fluid tests to screen and diagnose periprosthetic joint infection (PJI) in patients with inflammatory arthritis, only a single study has investigated this area. We aimed to assess accuracy of clinical and laboratory markers for PJI diagnosis in the context of underlying inflammatory arthritis. METHODS: This multicenter study was conducted on total joint arthroplasty patients at 3 different centers between 2001 and 2016...
July 24, 2018: Journal of Arthroplasty
Antonios Stylianakis, Georgios Schinas, Pavlos C Thomaidis, Joseph Papaparaskevas, Dimitrios C Ziogas, Maria N Gamaletsou, George L Daikos, Spyros Pneumaticos, Nikolaos V Sipsas
We assessed the value of conventional culture, vial culture, and broad-range PCR of the sonication fluid (SF), individually or in combinations, for the diagnosis of prosthetic joint infection (PJI). We studied 114 consecutive patients (median age:72.5 years, males: 28.07%) undergoing removal of a total knee or hip prosthesis. By non-microbiologic criteria, 87 patients had aseptic failure, and 27 PJI. All patients had periprosthetic tissue culture, sonication of prosthesis, and study of SF by conventional and vial culture, and PCR...
September 2018: Diagnostic Microbiology and Infectious Disease
Parikshaa Gupta, Gurwinder Kaur, Arvind Rajwanshi, Sandeep Bansal, Rajeev Kamble, R Ranjini
16-year-old male child. Presented with bilateral proptosis (more on right than left) over the last 8 years, which was painless and gradually increasing in size. He had slight blurring of vision in right eye with restriction of eye movements. In addition, he had difficulty in breathing from nose. There was no history of fever, fatigue, weight loss, night sweats or joint pains. The clinical suspicion was of a lymphoma or an invasive fungal infection. On examination, there was no significant cervical, axillary or inguinal lymphadenopathy or hepatosplenomegaly...
August 12, 2018: Cytopathology: Official Journal of the British Society for Clinical Cytology
Oyewole Christopher Durojaiye, Katharine Cartwright, Fotinie Ntziora
This study reviews the current OPAT service provision in the UK and evaluates concordance with the national OPAT practice guidelines (standards of care). We conducted a survey of acute hospital trusts and health boards in the UK regarding OPAT practices between June and September 2017. 165 (93%) of the 178 acute hospital trusts/health boards that were contacted responded to the survey. 100 (61%) indicated they had an OPAT service. Ten (10%) OPAT services did not involve an infection specialist. Bone and joint infections, and skin and soft-tissue infections were the most common conditions treated...
July 24, 2018: Diagnostic Microbiology and Infectious Disease
Sherwin K B Sy, Luning Zhuang, Serubbabel Sy, Hartmut Derendorf
Avibactam is a non-β-lactam, β-lactamase inhibitor of the diazabicyclooctane class that covalently acylates its β-lactamase targets, encompassing extended spectrum of activities that cover serine β-lactamases but not metallo-β-lactamases. Ceftazidime and avibactam have complementary pharmacokinetic (PK) profiles. Both drugs have a half-life of approximately 2 h, making them suitable to be combined in a fixed-dose combination ratio of 4:1 (ceftazidime:avibactam). Renal clearance is the primary elimination pathway of both ceftazidime and avibactam, and dose adjustment is required in patients with moderate and severe renal impairment...
August 11, 2018: Clinical Pharmacokinetics
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No abstract text is available yet for this article.
August 10, 2018: Surgical Infections
Antonia F Chen, Andrew Fleischman, Matthew S Austin
Intrawound antibiotics have been used in orthopaedic surgery procedures to prevent the development of surgical site infections. Local delivery of antibiotic powder has demonstrated a notable reduction in surgical site infection in rabbit and rodent in vivo models, as well as in other surgical fields, including vascular, colorectal, cardiothoracic, and dermatologic surgery. Intrawound antibiotic powder has been used in many orthopaedic applications, including spine surgery, total joint arthroplasty, trauma, foot and ankle reconstruction, and elbow surgery...
August 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
Cheng Hean Lo, Simone H Nothdurft, Hye-Sung Park, Eldho Paul, James Leong
Background: The purpose of this study is to present our experience with the modified pins and rubber band traction system, discuss problems encountered, and make recommendations to optimize outcomes. Methods: Data was collected prospectively from November 2013 to March 2017 at a tertiary referral hospital in Melbourne, Australia. Patients with closed complex proximal interphalangeal joint fracture dislocations that were considered unsuitable for other surgical options were included in the study...
2018: Burns and Trauma
Zhisen Gao, Xiang Li, Yinqiao Du, Yawen Peng, Wenming Wu, Yonggang Zhou
BACKGROUND The aim of this study was to investigate the success rate of fungal peri-prosthetic joint infection treated by 2-stage revision and related factors of treatment failure to offer a better treatment protocol. MATERIAL AND METHODS We reviewed 18 joints (13 knees and 5 hips) of 17 patients (10 women and 7 men) diagnosed with fungal peri-prosthetic joint infection from January 2000 to June 2015 at our institute. The mean follow-up was 65.1 months (range, 25-129 months). All joints were treated with complete debridement, implantation of antifungal-loaded cement spacers, at least 6 weeks of parenteral antifungal agents, and delayed reimplantation...
August 10, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Alexander J Rondon, Michael M Kheir, Timothy L Tan, Noam Shohat, Max R Greenky, Javad Parvizi
BACKGROUND: One of the most effective prophylactic strategies against periprosthetic joint infection (PJI) is administration of perioperative antibiotics. Many orthopedic surgeons are unaware of the weight-based dosing protocol for cefazolin. This study aimed at elucidating what proportion of patients receiving cefazolin prophylaxis are underdosed and whether this increases the risk of PJI. METHODS: A retrospective study of 17,393 primary total joint arthroplasties receiving cefazolin as perioperative prophylaxis from 2005 to 2017 was performed...
July 5, 2018: Journal of Arthroplasty
Michael M Kheir, Timothy L Tan, Colin T Ackerman, Ronuk Modi, Carol Foltz, Javad Parvizi
BACKGROUND: Owing to the difficulty isolating microorganisms in periprosthetic joint infection (PJI), current guidelines recommend that 3-5 intraoperative samples be cultured and maintained for 3-14 days. We investigated (1) the optimal number of culture samples and growth duration to diagnose PJI and (2) the microbiology profile at our institution. METHODS: A retrospective review of 711 patients (329 hips, 382 knees) with PJI that met Musculoskeletal Infection Society criteria from 2000 to 2014 was performed...
July 11, 2018: Journal of Arthroplasty
Dehong Yang, Xiaoliang Wu, Minghui Zheng, Jixing Wang
OBJECTIVES: To introduce a modified percutaneous endoscopic lumbar discectomy (PELD) technique to remove extraforaminal disc herniation at L5/S1 segment, including the technical essentials and preliminary results. MATERIALS AND METHODS: The geometric parameters of the transverse process, facet joint and sacrum (TFS) space based on imaging examination were measured in 100 common patients. The technical essentials including working cannula placement and disc removing involved in the technique were described...
August 6, 2018: World Neurosurgery
Marjan Wouthuyzen-Bakker, Marine Sebillotte, Jose Lomas, Adrian Taylor, Eva Benavent Palomares, Oscar Murillo, Javad Parvizi, Noam Shohat, Javier Cobo Reinoso, Rosa Escudero Sánchez, Marta Fernandez-Sampedro, Eric Senneville, Kaisa Huotari, José Maria Barbero Allende, Joaquín Garcia-Cañete, Jaime Lora-Tamayo, Matteo Carlo Ferrari, Danguole Vaznaisiene, Erlangga Yusuf, Craig Aboltins, Rihard Trebse, Mauro José Salles, Natividad Benito, Andrea Vila, Maria Dolores Del Toro, Tobias Siegfried Kramer, Sabine Petersdorf, Vicens Diaz-Brito, Zeliha Kocak Tufan, Marisa Sanchez, Cédric Arvieux, Alex Soriano
OBJECTIVES: Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI), but its efficacy in patients with late acute (LA) PJI is not well described. METHODS: Patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the development of acute symptoms (≤ 3 weeks) occurring ≥ 3 months after arthroplasty. Failure was defined as: i) the need for implant removal, ii) infection related death, iii) the need for suppressive antibiotic therapy and/or iv) relapse or reinfection during follow-up...
August 6, 2018: Journal of Infection
Jaiben George, Jared M Newman, Mhamad Faour, William Messner, Alison K Klika, Wael K Barsoum, Carlos A Higuera
Although total hip arthroplasty and total knee arthroplasty commonly overlap, there are concerns about the safety and quality of this scenario. The objectives of this study were to (1) compare the operative time and the incidence of 90-day complications between overlapping and nonoverlapping total joint arthroplasties; and (2) evaluate the effect of the duration of overlap on operative time and the incidence of 90-day complications. A total of 9192 patients who underwent primary total hip arthroplasty or total knee arthroplasty at a large academic hospital from 2005 to 2014 were identified...
August 9, 2018: Orthopedics
David C Shih, P Maureen Cassidy, Kiran M Perkins, Matthew B Crist, Paul R Cieslak, Richard L Leman
Nontuberculous mycobacteria (NTM), ubiquitous in soil and water, usually infect immunocompromised persons. However, even healthy persons are susceptible to infection through percutaneous inoculation. Although 77% of NTM diseases manifest as primarily pulmonary illnesses (1), NTM also infect skin, bones, joints, the lymphatic system, and soft tissue. NTM infections can have incubation periods that exceed 5 years (2), often require prolonged treatment, and can lead to sepsis and death. Extrapulmonary NTM outbreaks have been reported in association with contaminated surgical gentian violet (3), nail salon pedicures (4), and tattoos received at tattoo parlors (5), although few surveillance data have been available for estimating the public health burden of NTM...
August 10, 2018: MMWR. Morbidity and Mortality Weekly Report
Catherine L Searle, Baylie R Hochstedler, Abigail M Merrick, Juliana K Ilmain, Maggie A Wigren
It is well-established that both resources and infectious disease can influence species invasions, but little is known regarding interactive effects of these two factors. We performed a series of experiments to understand how resources and parasites can jointly affect the ability of a freshwater invasive zooplankton to establish in a population of a native zooplankton. In a life history trial, we found that both species increased offspring production to the same degree as algal resources increased, suggesting that changes in resources would have similar effects on both species...
August 7, 2018: Oecologia
C Llorens, S C Arcos, L Robertson, R Ramos, R Futami, B Soriano, S Ciordia, M Careche, M González-Muñoz, Y Jiménez-Ruiz, N Carballeda-Sangiao, I Moneo, J P Albar, M Blaxter, A Navas
BACKGROUND: Anisakis simplex sensu stricto and Anisakis pegreffii are sibling species of nematodes parasitic on marine mammals. Zoonotic human infection with third stage infective larvae causes anisakiasis, a debilitating and potentially fatal disease. These 2 species show evidence of hybridisation in geographical areas where they are sympatric. How the species and their hybrids differ is still poorly understood. RESULTS: Third stage larvae of Anisakis simplex s...
August 7, 2018: BMC Genomics
Johan A Maertens, Corrado Girmenia, Roger J Brüggemann, Rafael F Duarte, Christopher C Kibbler, Per Ljungman, Zdenek Racil, Patricia Ribaud, Monica A Slavin, Oliver A Cornely, J Peter Donnelly, Catherine Cordonnier
The European Conference on Infections in Leukaemia (ECIL) updated its guidelines on antifungal prophylaxis for adults using the grading system of IDSA. The guidelines were extended to provide recommendations for other haematological diseases besides AML and recipients of an allogeneic haematopoietic stem cell transplantation (HSCT). Posaconazole remains the drug of choice when the incidence of invasive mould diseases exceeds 8%. For patients undergoing remission-induction chemotherapy for AML and myelodysplastic syndrome (MDS), fluconazole can still offer an alternative provided it forms part of an integrated care strategy that includes screening with biomarkers and imaging...
August 1, 2018: Journal of Antimicrobial Chemotherapy
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