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Prosthetic joint infection

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https://www.readbyqxmd.com/read/28541804/introduction-to-the-centers-for-disease-control-and-prevention-and-the-healthcare-infection-control-practices-advisory-committee-guideline-for-the-prevention-of-surgical-site-infections
#1
Joseph S Solomkin, John Mazuski, Joan C Blanchard, Kamal M F Itani, Philip Ricks, E Patchen Dellinger, George Allen, Rachel Kelz, Caroline E Reinke, Sandra I Berríos-Torres
Surgical site infection (SSI) is a common type of health-care-associated infection (HAI) and adds considerably to the individual, social, and economic costs of surgical treatment. This document serves to introduce the updated Guideline for the Prevention of SSI from the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). The Core section of the guideline addresses issues relevant to multiple surgical specialties and procedures. The second procedure-specific section focuses on a high-volume, high-burden procedure: Prosthetic joint arthroplasty...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28540150/brucella-melitensis-prosthetic-joint-infection
#2
Domenica Flury, Henrik Behrend, Parham Sendi, Matthias von Kietzell, Carol Strahm
Periprosthetic joint infection (PJI) due to Brucella spp. is rare. We report a case in a 75-year-old man and review 29 additional cases identified in a literature search. The diagnosis of Brucella PJI is challenging, in particular in non-endemic countries. Serological tests prior to joint aspiration or surgical intervention are reasonable. Involvement of infection control and timely information to laboratory personnel is mandatory upon diagnosis. There is no uniform treatment concept, neither with respect to surgical intervention nor for the duration of antimicrobials...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28540149/treatment-challenges-of-prosthetic-hip-infection-with-associated-iliacus-muscle-abscess-report-of-5-cases-and-literature-review
#3
Joshua M Lawrenz, Nathan W Mesko, Carlos A Higuera, Robert M Molloy, Claus Simpfendorfer, Maja Babic
Prosthetic joint infection is an unfortunate though well-recognized complication of total joint arthroplasty. An iliacus and/or iliopsoas muscle abscess is a rarely documented presentation of hip prosthetic joint infection. It is thought an unrecognized retroperitoneal nidus of infection can be a source of continual seeding of the prosthetic hip joint, prolonging attempts to eradicate infection despite aggressive debridement and explant attempts. The current study presents five cases demonstrating this clinical scenario, and discusses various treatment challenges...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28540148/clinical-and-microbiological-characteristics-of-bacteroides-prosthetic-joint-infections
#4
Neel Shah, Douglas Osmon, Aaron J Tande, James Steckelberg, Rafael Sierra, Randall Walker, Elie F Berbari
Clinical and microbiological characteristics of patients with Bacteroides prosthetic joint infection (PJI) have not been well described in the literature. The aim of this retrospective cohort study was to assess the outcome of patients with Bacteroides PJI and to review risk factors associated with failure of therapy. Between 1/1969 and 12/2012, 20 episodes of Bacteroides PJI in 17 patients were identified at our institution. The mean age of the patients in this cohort at the time of diagnosis was 55.6 years; 59% (n=10) had knee involvement...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28540147/candida-prosthetic-joint-infection-a-review-of-treatment-methods
#5
REVIEW
Fernando Cobo, Javier Rodríguez-Granger, Antonio Sampedro, Luis Aliaga-Martínez, José María Navarro-Marí
Fungal microorganisms are still a rare cause of bone and joint infections. We report a new case of knee prosthetic joint infection due to Candida albicans in a patient with a previous two-stage right knee arthroplasty for septic arthritis due to S. epidermidis occurred several months ago. Moreover, the treatment in 76 cases of Candida prosthetic joint infection has been discussed. Forty patients were female and mean age at diagnosis was 65.7 (± SD 18) yrs. No risk factors for candidal infection were found in 25 patients...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28540146/-combined-diagnostic-tool-application-to-a-retrospective-series-of-patients-undergoing-total-joint-revision-surgery
#6
Enrico Gallazzi, Lorenzo Drago, Andrea Baldini, Ian Stockley, David A George, Sara Scarponi, Carlo L Romanò
Background: Differentiating between septic and aseptic joint prosthesis may be challenging, since no single test is able to confirm or rule out infection. The choice and interpretation of the panel of tests performed in any case often relies on empirical evaluation and poorly validated scores. The "Combined Diagnostic Tool (CDT)" App, a smartphone application for iOS, was developed to allow to automatically calculate the probability of having a of periprosthetic joint infection, on the basis of the relative sensitivity and specificity of the positive and negative diagnostic tests performed in any given patient...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28532409/variation-in-prosthetic-joint-infection-and-treatment-strategies-during-4-5%C3%A2-years-of-follow-up-after-primary-joint-arthroplasty-using-administrative-data-of-41397-patients-across-australian-european-and-united-states-hospitals
#7
Perla J Marang-van de Mheen, Ellie Bragan Turner, Susan Liew, Nora Mutalima, Ton Tran, Sten Rasmussen, Rob G H H Nelissen, Andrew Gordon
BACKGROUND: To identify best practices and quality improvement initiatives, we aimed to assess whether the incidence of Periprosthetic Joint Infection (PJI) and treatment strategies differed across patients treated in Australian, European and United States (US) hospitals. METHODS: Routinely collected administrative data for 41397 patients undergoing a primary total hip or knee arthroplasty between July 2007-December 2010 across 22 hospitals were included. Patients were followed for 2 years looking for PJI occurrence, defined as early (within 4 weeks) and late PJI, and surgical treatment during 2...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28530395/rapid-detection-of-prosthetic-joint-infection-based-on-magnetically-assisted-surface-enhanced-raman-spectroscopy-ma-sers
#8
Ariana Fargasova, Anna Balzerova, Robert Prucek, Miroslava Htoutou Sedláková, Katerina Bogdanova, Jiri Gallo, Milan Kolar, Vaclav Ranc, Radek Zboril
Accurate and rapid diagnosis of prosthetic joint infection (PJI) is vital for rational and effective therapeutic management of this condition. Several diagnostic strategies have been developed for discriminating between infected and non-infected cases. However, none of them can reliably diagnose the whole spectrum of clinical presentations of PJI. Here we report a new method for PJI detection based on magnetically assisted surface enhanced Raman spectroscopy (MA-SERS) using streptavidin-modified magnetic nanoparticles (MNP@Strep) whose surface is functionalized with suitable biotinylated antibodies and then coated with silver nanoparticles by self-assembly...
May 22, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28529867/efficacy-of-antibiotic-suppressive-therapy-in-patients-with-a-prosthetic-joint-infection
#9
Marjan Wouthuyzen-Bakker, Jasperina M Nijman, Greetje A Kampinga, Sander van Assen, Paul C Jutte
Introduction: For chronic prosthetic joint infections (PJI), complete removal of the infected prosthesis is necessary in order to cure the infection. Unfortunately, a subgroup of patients is not able to undergo a revision surgery due to high surgical risk. Alternatively, these patients can be treated with antibiotic suppressive therapy (AST) to suppress the infection. Aim: To evaluate the efficacy and tolerability of AST. Methods: We retrospectively collected data (period 2009-2015) from patients with a PJI (of hip, knee or shoulder) who were treated with AST at the University Medical Center Groningen, the Netherlands...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529860/use-of-chlorhexidine-preparations-in-total-joint-arthroplasty
#10
REVIEW
Jaiben George, Alison K Klika, Carlos A Higuera
Prosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Chlorhexidine is a widely used antiseptic because of its rapid and persistent action. It is well tolerated and available in different formulations at various concentrations. Chlorhexidine can be used for pre-operative skin cleansing, surgical site preparation, hand antisepsis of the surgical team and intra-articular irrigation of infected joints. The optimal intra-articular concentration of chlorhexidine gluconate in irrigation solution is 2%, to provide a persistent decrease in biofilm formation, though cytotoxicity might be an issue...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529343/excellent-auc-for-joint-fluid-cytology-in-the-detection-exclusion-of-hip-and-knee-prosthetic-joint-infection
#11
Jiri Gallo, Jarmila Juranova, Michal Svoboda, Jana Zapletalova
BACKGROUND AND AIM: The aim of this study was to evaluate the characteristics of synovial fluid (SF) white cell count (SWCC) and neutrophil/lymphocyte percentage in the diagnosis of prosthetic joint infection (PJI) for particular threshold values. METHODS AND RESULTS: This was a prospective study of 391 patients in whom SF specimens were collected before total joint replacement revisions. SF was aspirated before joint capsule incision. The PJI diagnosis was based only on non-SF data...
May 15, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28529089/kinetics-of-biofilm-formation-by-staphylococcus-lugdunensis-strains-in-bone-and-joint-infections
#12
Xavier Argemi, Gilles Prévost, Philippe Riegel, Christian Provot, Stéphanie Badel-Berchoux, François Jehl, Elodie Olivares, Yves Hansmann
OBJECTIVE: To describe the clinical presentation and 1-year follow-up of patients with bone and joint infections (BJIs) caused by Staphylococcus lugdunensis and evaluate its biofilm-forming capacities. PATIENTS AND METHODS: Overall, 28 patients with BJIs from VISLISI clinical trials were included. We evaluated 1-year clinical follow-up and analyzed biofilm production kinetics of the 28 strains using the BioFilm Ring Test®. RESULTS: Of all patients, 12 had osteoarticular infections without material and 16 had prosthetic joint infections, of which 9 underwent a 1-stage revision procedure...
May 12, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28526565/efficacy-of-indefinite-chronic-oral-antimicrobial-suppression-for-prosthetic-joint-infection-in-the-elderly-a-comparative-study
#13
V Prendki, P Sergent, A Barrelet, E Oziol, E Beretti, M Berlioz-Thibal, F Bouchand, F Dauchy, E Forestier, G Gavazzi, C Ronde-Oustau, J Stirnemann, A Dinh
OBJECTIVES: During prosthetic joint infection (PJI), surgical management is sometimes impossible, indefinite chronic oral antimicrobial suppression (ICOAS) may sometimes be the only option. We evaluated the outcome of elderly patients who benefited from ICOAS for a strictly palliative goal METHODS: We performed a national retrospective cohort study in France of patients aged >75years old with PJI, and managed with ICOAS planned for life long from 2009 to 2014, and compared the population with an event versus the population free of event...
May 16, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28522245/pin-site-complications-associated-with-computer-assisted-navigation-in-hip-and-knee-arthroplasty
#14
Eli Kamara, Zachary P Berliner, Matthew S Hepinstall, H John Cooper
BACKGROUND: There has been a great increase in the use of navigation technology in joint arthroplasty. In most types of navigation-assisted surgery, several temporary navigation pins are placed in the patient. Goals of this study are (1) to identify complications and (2) risk factors associated with placement of these pins. METHODS: This is a retrospective cohort study of all navigation-assisted hip and knee arthroplasty performed a single institution over a 3-year period...
April 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28522189/preoperative-joint-aspiration-in-the-diagnosis-of-non-acute-hip-and-knee-prosthetic-joint-infections
#15
A Bicart-See, J Lourtet, C Delpierre, C Livideanu, T Pollon, J Remi, M P Felice, G Giordano, E Bonnet
No abstract text is available yet for this article.
May 15, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28490492/molecular-diagnosis-of-orthopaedic-device-infection-direct-from-sonication-fluid-by-metagenomic-sequencing
#16
Teresa L Street, Nicholas D Sanderson, Bridget L Atkins, Andrew J Brent, Kevin Cole, Dona Foster, Martin A McNally, Sarah Oakley, Leon Peto, Adrian Taylor, Tim E A Peto, Derrick W Crook, David W Eyre
Culture of multiple periprosthetic tissue samples is the current gold-standard for microbiological diagnosis of prosthetic joint infections (PJI). Additional diagnostic information may be obtained through sonication fluid culture of explants. However, current techniques can have relatively low sensitivity, with prior antimicrobial therapy and infection by fastidious organisms influencing results. We assessed if metagenomic sequencing of total DNA extracts obtained direct from sonication fluid can provide an alternative rapid and sensitive tool for diagnosis of PJI...
May 10, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28488017/c-reactive-protein-course-during-the-first-5-days-after-total-knee-arthroplasty-cannot-predict-early-prosthetic-joint-infection
#17
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection...
May 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28483043/diagnosis-of-prosthetic-joint-infection-cultures-biomarker-and-criteria
#18
REVIEW
Eric O Gomez-Urena, Aaron J Tande, Douglas R Osmon, Elie F Berbari
Prosthetic joint infections (PJIs) are devastating complications after joint arthroplasty that continue to pose a diagnostic challenge. Currently, a single, stand-alone test with the adequate accuracy and reliability for diagnosis of PJI is not available; therefore, physicians who care for patients with PJI must rely on a combination of diagnostic tests for the diagnosis of PJI. This article reviews conventional laboratory test modalities, diagnostic accuracy and limitations of current tests, and novel emerging tests for the diagnosis of PJI...
June 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28480283/using-nuclear-medicine-imaging-wisely-in-diagnosing-infectious-diseases
#19
REVIEW
Andrea Censullo, Tara Vijayan
In recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine's "Choosing Wisely" campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad. This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28479058/how-many-cultures-are-necessary-to-identify-pathogens-in-the-management-of-total-hip-and-knee-arthroplasty-infections
#20
Rikesh Gandhi, Edward Silverman, Paul M Courtney, Gwo-Chin Lee
BACKGROUND: Identification of the infecting organism is critical to the successful management of deep prosthetic joint infections about the hip and the knee. However, the number of culture specimens and which culture specimens are best to identify these organisms is unknown. METHODS: We evaluated 113 consecutive patients with infected total hip and total knee arthroplasties and correlated the type of culture specimen and number of specimens taken during surgery to the likelihood of a positive culture result...
April 14, 2017: Journal of Arthroplasty
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