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Prosthetic AND Joint AND infection

Jc Rodríguez Duque, P Galindo Rubín, B González Humara, Aa Quesada Sanz, Mb Busta Vallina, M Fernández-Sampedro
No abstract text is available yet for this article.
August 14, 2018: Anaerobe
Robert Jay Rowen
The world is facing crisis in management of infectious diseases. The mainstay of treatment has been chemical anti-infectives. These drugs are failing, as superbugs emerge and medicine becomes more sophisticated with treatments such as prosthetic devices, which can harbor bacteria protected by biofilm. This case report describes a 68-year-old woman who received bilateral artificial hips on October 27, 2015. The right hip prosthesis subsequently became septic by June 2016. Three orthopedic surgeons offered her a several month program, which included removal of the prosthesis, implantation of an antibiotic impregnated "spacer" and months of intravenous antibiotics...
April 2018: Medical Gas Research
Martin Runnstrom, Ryan Hyde, Kairav Shah
No abstract text is available yet for this article.
2018: IDCases
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
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
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
O Lesens, T Ferry, E Forestier, E Botelho-Nevers, P Pavese, E Piet, B Pereira, E Montbarbon, B Boyer, S Lustig, S Descamps
To evaluate factors associated with failure in patients treated with DAIR (debridement, antibiotic therapy, and implant retention) for Staphylococcus aureus prosthetic joint infections (PJIs). We retrospectively analyzed consecutive patients with stable PJI due to S. aureus treated with DAIR at six hospitals between 2010 and 2014. Cox proportional hazards regression was used to study factors associated with treatment failure at 2 years. Of 154 eligible patients, 137 were included (mean age 73 ± 13 years; male 56%)...
August 7, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Kimberly Perez, Robin Patel
Staphylococcus epidermidis is a leading cause of infections associated with indwelling medical devices, including prosthetic joint infection. While biofilm formation is assumed to be the main mechanism underlying the chronic infections S. epidermidis causes, we hypothesized that S. epidermidis also evades immune killing, contributing to its pathogenesis. Here, we show that prosthetic joint-associated S. epidermidis isolates can persist intracellularly within human fibroblasts and inside human and mouse osteoblasts...
July 30, 2018: Infection and Immunity
Ronak A Patel, Hayden P Baker, Sara B Smith
Two-stage revision total knee arthroplasty (TKA) is the standard of care for prosthetic joint infections. The first stage involves removal of the infected prosthesis and placement of an antibiotic impregnated cement spacer; following a period ranging from 4 weeks to 6 months, the spacer is then removed and replaced with a permanent prosthesis. The advantage to this approach is that antibiotic impregnated spacers provide supratherapeutic levels in the joint without toxic accumulation in serum. However, it remains important for physicians and pharmacists to be aware of antibiotic associated complications in knee revisions...
2018: Case Reports in Nephrology
Cédric Arvieux, Harold Common
The diagnosis of peri-prosthetic bone and joint infections relies on converging information from clinical, laboratory, and imaging assessments. Clinical findings alone may suffice: a sinus tract is a major criterion that establishes the diagnosis of infection. Identifying the causative organism is crucial and requires the early collection of high-quality samples from sites in contact with the prosthetic material. The bacteriological samples may be obtained by aspiration or open surgery. Imaging techniques have undergone remarkable improvements over the last two decades...
July 26, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Erik Lenguerrand, Michael R Whitehouse, Andrew D Beswick, Setor K Kunutsor, Ben Burston, Martyn Porter, Ashley W Blom
BACKGROUND: The risk of prosthetic joint infection (PJI) is influenced by patient, surgical, and health-care factors. Existing evidence is based on short-term follow-up. It does not differentiate between factors associated with early onset caused by the primary intervention from those associated with later onset more likely to result from haematogenous spread. We aimed to assess the overall and time-specific associations of these factors with the risk of revision due to PJI after primary total hip replacement...
July 25, 2018: Lancet Infectious Diseases
Yoo Ra Lee, Hyun Jung Kim, Eun Ju Lee, Jang Wook Sohn, Min Ja Kim, Young Kyung Yoon
The purpose of this study was to evaluate the efficacy of echinocandins in the treatment of Candida prosthetic joint infection (PJI) based on published literature and on patients we examined. A structured literature review of multiple databases was conducted to identify patients who received echinocandins for Candida PJIs. Additionally, we describe here the first cases of PJIs due to C. parapsilosis, successfully treated with prolonged anidulafungin therapy. Out of 17 patients, 12 were female and the mean age at diagnosis was 66...
July 26, 2018: Mycopathologia
Qun Yan, Melissa J Karau, Yash S Raval, Robin Patel
This study evaluated the in vitro activity of oritavancin in combination with rifampin or gentamicin against methicillin-resistant Staphylococcus epidermidis (MRSE) biofilms. Oritavancin, rifampin and gentamicin were tested against 20 MRSE isolates recovered from prosthetic joint infection (PJI). Time-kill studies were used to evaluate the activities of the three antimicrobial agents individually versus combinations of oritavancin with rifampin or gentamicin against MRSE biofilms formed on Teflon coupons. At 24 hours, the combination of oritavancin and rifampin resulted in a significant (P ≤0...
July 23, 2018: International Journal of Antimicrobial Agents
Qingyu Zhang, Lihua Liu, Wei Sun, Fuqiang Gao, Qidong Zhang, Liming Cheng, Zirong Li
BACKGROUND: Placement of closed suction drains after total knee arthroplasty is an age-old practice; however, benefits and disadvantages of this procedure remain disputable in various studies. METHODS: We performed an electronic database search in Medline/PubMed, the Cochrane Library, and Embase to retrieve publications with respect to this issue and then screened reference lists of related articles manually to obtain any additional ones. Randomized controlled trials (RCTs) evaluating the use of closed suction drains after primary total knee arthroplasty were eligible for this study...
July 2018: Medicine (Baltimore)
Claire Triffault-Fillit, Florent Valour, Ronan Guillo, Michel Tod, Sylvain Goutelle, Sébastien Lustig, Michel-Henry Fessy, Christian Chidiac, Tristan Ferry
Objectives: The empirical use of vancomycin in combination with a broad-spectrum betalactam is currently recommended after the initial surgery of prosthetic joint infection (PJI). However, the tolerability of such high-dose intravenous regimens is poorly known. Patient and methods: Adult patients receiving an empirical antimicrobial therapy (EAT) for a PJI were enrolled in a prospective cohort study (2011-2016). EAT-related adverse events (AE) were described according to the common terminology criteria for AE (CTCAE), and their determinants were assessed by logistic regression and Kaplan-Meier curve analysis...
July 23, 2018: Antimicrobial Agents and Chemotherapy
Irene Katharina Sigmund, Katsiaryna Yermak, Carsten Perka, Andrej Trampuz, Nora Renz
BACKGROUND: Alpha defensin was proposed as a new biomarker in synovial fluid for the diagnostic workup of failed joint prostheses. To our knowledge, no comparative study of the performance of the quantitative enzyme-linked immunosorbent assay (ELISA) and qualitative lateral flow alpha defensin test has been reported. QUESTIONS/PURPOSES: (1) Using the proposed European Bone and Joint Infection Society (EBJIS) criteria for defining periprosthetic joint infection (PJI), is there a difference in the diagnostic accuracy of quantitative ELISA and qualitative lateral flow alpha defensin tests? (2) Is there a difference in the performance of the two alpha defensin tests when using three definition classification systems (Musculoskeletal Infection Society [MSIS], Infectious Diseases Society of America [IDSA], and proposed EBJIS)? METHODS: In this retrospective study of samples collected earlier as part of a related longitudinal study, we included patients in whom aspiration of the prosthetic hip or knee was performed as routine investigation before every revision arthroplasty...
August 2018: Clinical Orthopaedics and related Research
Jesse W P Kuiper, Christine M E Rustenburg, Jore H Willems, Steven J Verberne, Edgar J G Peters, Rachid Saouti
Background : Little is known about functional outcome and quality of life (QoL) after one-stage revision for periprosthetic joint infection (PJI) of the hip. Methods : a cohort of 30 subjects treated with one-stage revision between 2011 and 2015 was identified, and questionnaires on functional outcome and QoL were distributed. Results : 28 subjects were successfully treated (93%). Most subjects were referred from other hospitals. Coagulase-negative Staphylococcus was found in 50% of the cases, and 40% of all cultured bacteria were multidrug-resistant...
2018: Journal of Bone and Joint Infection
Lieke M A de Vries, William C Neve, Jeroen Steens
Background : A prosthetic joint infection (PJI) is a serious complication and specifically a burden for patients after hip fracture surgery, as they are mostly frail elderly patients with multiple comorbidities. Since treatment protocols are lacking there is a need to evaluate current practice. Aim: To evaluate the difference in prosthesis retention after an infected primary total hip replacement (THR) compared to PJI after hip prosthesis surgery performed for a hip fracture. Methods: We retrospectively collected data of patients who developed PJI after primary THR or after hip fracture surgery (THR or hemiarthroplasty) in the Westfriesgasthuis Hospital between 1998 and 2015...
2018: Journal of Bone and Joint Infection
Ricardo Sousa, Miguel Araújo Abreu
Prosthetic joint infection usually requires combined medical and surgical therapy. While revision surgery is widely considered to be the gold standard surgical procedure, debridement, antibiotics and irrigation with implant retention is a very appealing alternative. There is however great controversy regarding its real worth with success rates ranging from 0% to over 90%. A number of different patient and host related variables as well as specific aspects of surgical and medical management have been described as relevant for the final outcome...
2018: Journal of Bone and Joint Infection
Qun Yan, Melissa J Karau, Yash S Raval, Robin Patel
The anti-biofilm activity of oritavancin in combination with rifampin, gentamicin or linezolid was evaluated against ten prosthetic joint infection (PJI) related methicillin-resistant Staphylococcus aureus (MRSA) by time-kill assays. Oritavancin combined with rifampin demonstrated statistically significant bacterial reductions compared to either antimicrobial alone for all ten isolates (P ≤0.001), with synergy being observed for 80% (8/10) of the isolates. Oritavancin and rifampin combination therapy may be an option for treating MRSA PJI...
July 16, 2018: Antimicrobial Agents and Chemotherapy
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