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Prosthetic joint infection

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https://www.readbyqxmd.com/read/27883369/acinetobacter-prosthetic-joint-infection-treated-with-debridement-and-high-dose-tigecycline
#1
Andrea Vila, Hugo Pagella, Claudio Amadio, Alejandro Leiva
Prosthesis retention is not recommended for multidrug-resistant Acinetobacter prosthetic joint infection due to its high failure rate. Nevertheless, replacing the prosthesis implies high morbidity and prolonged hospitalization. Although tigecycline is not approved for the treatment of prosthetic joint infection due to multidrug resistant Acinetobacter baumannii, its appropriate use may preclude prosthesis exchange. Since the area under the curve divided by the minimum inhibitory concentration is the best pharmacodynamic predictor of its efficacy, we used tigecycline at high dose, in order to optimize its efficacy and achieve implant retention in 3 patients who refused prosthesis exchange...
November 8, 2016: Infection & Chemotherapy
https://www.readbyqxmd.com/read/27869495/a-comparison-of-airborne-bacterial-fallout-between-orthopaedic-and-vascular-surgery
#2
P Stather, M Salji, S-U Hassan, M Abbas, A Ahmed, H Mills, T Elston, C Backhouse, A Howard, S Choksy
INTRODUCTION The objective of the study was to compare bacterial fallout during vascular prosthesis insertion and orthopaedic major joint replacement performed in conventional and laminar flow ventilation, respectively. MATERIALS AND METHODS A prospective single-centre case control study of 21 consecutive elective vascular procedures involving prosthetic graft insertion and 24 consecutive elective orthopaedic major joint replacements were tested for degree of bacterial fallout using agar settle plates. Preparation time, waiting time and total procedure duration were collected at the time of surgery, and bacterial colony counts on the agar settle plates from airborne bacterial fallout were counted after an incubation period...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27869063/screening-patients-undergoing-total-hip-or-knee-arthroplasty-with-perioperative-urinalysis-and-the-effect-of-a-practice-change-on-antimicrobial-use
#3
Samuel Bailin, Nicolas Noiseux, Jean M Pottinger, Birgir Johannsson, Ambar Haleem, Sarah Johnson, Loreen A Herwaldt
OBJECTIVE To identify predictors of treatment for urinary tract infections (UTI) among patients undergoing total hip (THA) or knee (TKA) arthroplasties and to assess an intervention based on these predictors. DESIGN We conducted a retrospective cohort study of 200 consecutive patients undergoing THA/TKA between February 21, 2011, and June 30, 2011, to identify predictors of treatment for UTI and a prospective cohort study of 50 patients undergoing these procedures between May 21, 2012, and July 17, 2012, to assess the association of signs or symptoms and UTI treatment...
November 21, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27855064/rifampin-based-combination-therapy-is-active-in-foreign-body-osteomyelitis-after-prior-rifampin-monotherapy
#4
Cassandra L Brinkman, Suzannah M Schmidt-Malan, Jayawant N Mandrekar, Robin Patel
Staphylococcal prosthetic joint infections (PJIs) are associated with biofilm formation, making them difficult to treat; if managed with débridement and implant retention, rifampin-based therapy is usually employed. Rifampin resistance potentially challenges PJI treatment. In investigating the effects of rifampin monotherapy on methicillin-resistant Staphylococcus aureus (MRSA) foreign body osteomyelitis in rats, we previously demonstrated that rifampin resistance was selected but that it disappeared 14 days following rifampin monotherapy (1) and that rifampin resistance occurred less frequently following two rounds than one round of rifampin monotherapy (2)...
November 14, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27852674/focus-on-mrsa-sa-ssti%C3%A2-assay-failure-in-prosthetic-joint-infections-213-consecutive-patients-later
#5
Marie Titécat, Frédéric Wallet, Olivier Robineau, Michel Valette, Henri Migaud, Eric Senneville, Caroline Loïez
In prosthetic joint infection (PJI) cases (1), rapid detection of methicillin-resistant staphylococci (MRS) is the key to avoid the use of broad-spectrum antimicrobials such as vancomycin.….
November 16, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27847676/retentive-cup-arthroplasty-in-selected-hip-fracture-patients-a-prospective-series-with-a-minimum-3-year-follow-up
#6
Mustafa Yassin, Avraham Garti, Muhammad Khatib, Moshe Weisbrot, Dror Robinson
OBJECTIVE: To evaluate the efficacy of the use of retentive cup primary total hip replacement (THR) in high-dislocation risk subcapital fracture patients. METHODS: During the years 2008 to 2012, 354 patients with displaced subcapital fracture were operated at our institute. The patients were selected to undergo primary constrained THR according to the following criteria: (1) a preinjury grade 4 or more on the Functional Independence Measure mobility item "5. Locomotion: walking/wheelchair" and grade 4 is defined as "4...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/27833769/first-case-report-of-a-late-onset-knee-periprosthetic-joint-infection-caused-by-lactococcus-garvieae
#7
V-I Neagoe, S Zytoun, H-J Neuhaus
Lactococcus garvieae is known as a Gram-positive, catalase-negative, and facultatively anaerobic fish pathogen. The association between Lactococcus spp. and human infectious diseases is described as being mainly associated with lumbar osteomyelitis, hepatic abscess, and infective endocarditis. In the literature of orthopedic post-prosthetic infections, L. garvieae was associated with a case of hip prosthetic infection in a fishmonger woman. We present the case of a 79-year-old male patient with multiple comorbidities, who is admitted to our center with a 5-day history of pain, swelling, and motility disorder of the right knee by the presence of a bicondylar knee replacement surgery, which was performed due to gonarthrosis 17 years ago...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27829328/use-of-oritavancin-novel-new-lipoglycopeptide-in-the-treatment-of-prosthetic-joint-infections-pji-a-possible-alternative-novel-approach-to-a-difficult-problem
#8
Suresh Jude Antony, Leigh G Cooper
Prosthetic joint infections (PJI) result in significant morbidity, mortality and cost to patients and the health system. Traditional treatment involves a two-staged revision and occasionally a single staged revision along with intravenous antibiotics (IV) and or oral antibiotics for several weeks to months. The use of a single staged revision along with an antibiotic which has a prolonged half life and is bactericidal would be ideal. We present 2 patients who were treated successfully with a single stage revision/antibiotic spacer and a new novel long acting lipoglycopeptide called oritavancin...
November 8, 2016: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/27825396/prosthetic-joint-infection-following-invasive-dental-procedures-and-antibiotic-prophylaxis-in-patients-with-hip-or-knee-arthroplasty
#9
Feng-Chen Kao, Yao-Chun Hsu, Wen-Hui Chen, Jiun-Nong Lin, Ying-Ying Lo, Yuan-Kun Tu
OBJECTIVES We aimed to clarify whether invasive dental treatment is associated with increased risk of prosthetic joint infection (PJI) and whether prophylactic antibiotics may lower the infection risk remain unclear. DESIGN Retrospective cohort study. PARTICIPANTS All Taiwanese residents (N=255,568) who underwent total knee or hip arthroplasty between January 1, 1997, and November 30, 2009, were screened. METHODS The dental cohort consisted of 57,066 patients who received dental treatment and were individually matched 1:1 with the nondental cohort by age, sex, propensity score, and index date...
November 9, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27815925/microbiological-diagnosis-of-implant-related-infections-scientific-evidence-and-cost-benefit-analysis-of-routine-antibiofilm-processing
#10
Lorenzo Drago, Elena De Vecchi
Prosthetic joint infection is one of the most severe complication following joint arthroplasty, producing a significant worsening of patient's quality of life. Management of PJIs requires extended courses of antimicrobial therapy, multiple surgical interventions and prolonged hospital stay, with a consequent economic burden, which is thought to markedly increase in the next years due to the expected burden in total joint arthroplasties. The present review summarizes the present knowledge on microbiological diagnosis of prosthetic joint infections, focusing on aethiological agents and discussing pros and cons of the available strategies for their diagnosis...
November 5, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27814684/remote-transient-lactobacillus-animalis-bacteremia-causing-prosthetic-hip-joint-infection-a-case-report
#11
R Somayaji, T Lynch, J N Powell, D Gregson
BACKGROUND: Lactobacillus spp. are uncommon pathogens in immunocompetent hosts, and even rarer causes of prosthetic device infections. CASE PRESENTATION: A case of chronic hip prosthetic joint infection (PJI) caused by L. animalis is described. This occurred 5 years after a transient bacteremia with the same organism. Whole genome sequencing of both isolates proved this PJI infection resulted from this remote bacteremia. CONCLUSIONS: We document that prosthetic joint infections may be a consequence of bacteremia as much as 3 years before the onset of symptoms...
November 4, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27807152/optimal-periprosthetic-tissue-specimen-number-for-diagnosis-of-prosthetic-joint-infection
#12
Trisha N Peel, Tim Spelman, Brenda L Dylla, John G Hughes, Kerryl E Greenwood-Quaintance, Allen C Cheng, Jayawant N Mandrekar, Robin Patel
We recently demonstrated improved sensitivity of prosthetic joint infection (PJI) diagnosis using an automated blood culture bottle system for periprosthetic tissue culture (mBio 7 (1):e01776-157, 2016, doi: 10.1128/mBio.01776-15). This study builds on the prior research, by examining the optimal number of periprosthetic tissue specimens required for accurate PJI diagnosis. Current guidelines recommend five to six, which is impractical. We applied Bayesian latent class modeling techniques for estimating diagnostic test properties of conventional culture techniques (aerobic and anaerobic agars and thioglycollate broth) compared to inoculation into blood culture bottles...
November 2, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27803223/international-consensus-on-the-definition-and-classification-of-fibrosis-of-the-knee-joint
#13
N S Kalson, L A Borthwick, D A Mann, D J Deehan, P Lewis, C Mann, M A Mont, R Morgan-Jones, S Oussedik, F M K Williams, A Toms, J N Argenson, J Bellemans, A Bhave, O Furnes, H Gollwitzer, F S Haddad, S Hofmann, V Krenn
AIMS: The aim of this consensus was to develop a definition of post-operative fibrosis of the knee. PATIENTS AND METHODS: An international panel of experts took part in a formal consensus process composed of a discussion phase and three Delphi rounds. RESULTS: Post-operative fibrosis of the knee was defined as a limited range of movement (ROM) in flexion and/or extension, that is not attributable to an osseous or prosthetic block to movement from malaligned, malpositioned or incorrectly sized components, metal hardware, ligament reconstruction, infection (septic arthritis), pain, chronic regional pain syndrome (CRPS) or other specific causes, but due to soft-tissue fibrosis that was not present pre-operatively...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27784234/use-of-intra-articular-amphotericin-b-in-the-treatment-of-candida-parasilosis-and-albicans-in-prosthetic-joint-infections-pji-a-novel-approach-to-this-difficult-problem
#14
Suresh Jude Antony
Use of intra-articular antibiotics for the treatment of arthroplasty infections has gained some interest over the last few years. This method has several advantages including: lack of systemic toxicity, ease of administration, and potentially better cure rates. The treatment of fungal infections in prosthetic joint arthroplasties is problematic with high failure and recurrence rates. We present 2 patients with Candida parasilosis and Candida albicans infections within the arthroplasty that were successfully treated with a single stage revision/spacer placement in conjunction with the use of intra-articular amphotericin B...
October 26, 2016: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/27769681/evaluation-of-a-commercial-multiplex-pcr-unyvero-i60-%C3%A2-designed-for-the-diagnosis-of-bone-and-joint-infections-using-prosthetic-joint-sonication
#15
Laura Prieto-Borja, Graciela Rodriguez-Sevilla, Alvaro Auñon, Concepción Pérez-Jorge, Enrique Sandoval, Joaquín Garcia-Cañete, Ignacio Gadea, Ricardo Fernandez-Roblas, Antonio Blanco, Jaime Esteban
BACKGROUND: The development of sonication protocols over the last few years has improved the sensitivity of conventional cultures for the diagnosis of prosthetic-joint infection (PJI). However, the development of a new, specifically designed kit for the molecular diagnosis of PJI could provide a major improvement in this field. METHODS: Prostheses retrieved from patients who underwent implant removal from May 2014 to May 2015 were sent for culture, and processed according to a previously defined protocol that included sonication...
October 18, 2016: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/27769073/total-hip-arthroplasty-for-femoral-neck-fractures-improved-outcomes-with-higher-hospital-volumes
#16
Michael Maceroli, Lucas E Nikkel, Bilal Mahmood, John P Ketz, Xing Qiu, Joseph Ciminelli, Susan Messing, John C Elfar
OBJECTIVES: To determine if hospital arthroplasty volume affects patient outcomes after undergoing total hip arthroplasty (THA) for displaced femoral neck fractures. METHODS: The Statewide Planning and Research Cooperative System database from the New York State Department of Health was used to group hospitals into quartiles based on overall THA volume from 2000 to 2010. The database was then queried to identify all patients undergoing THA specifically for femoral neck fracture during this time period...
November 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27752973/tio2-containing-and-zno-containing-borosilicate-glass-a-novel-thin-glass-with-exceptional-antibiofilm-performances-to-prevent-microfouling
#17
Mareike Klinger-Strobel, Oliwia Makarewicz, Mathias W Pletz, Andreas Stallmach, Christian Lautenschläger
Biofilm formation, also known as microfouling, on indwelling medical devices such as catheters or prosthetic joints causes difficult to treat and recurrent infections. It is also the initial step for biocorrosion of surfaces in aquatic environment. An efficient prevention of microfouling is preferable but the development of antibiofilm surfaces is enormously challenging. Therefore, soda-lime, aluminosilicate, and three borosilicate glasses with different TiO2 and ZnO compositions were investigated on their feasibility to prevent biofilm formation by standardized in vitro biofilm assays using different pathogenic bacteria...
December 2016: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/27747252/role-of-suppressive-oral-antibiotics-in-orthopedic-hardware-infections-for-those-not-undergoing-two-stage-replacement-surgery
#18
Sara C Keller, Sara E Cosgrove, Yvonne Higgins, Damani A Piggott, Greg Osgood, Paul G Auwaerter
Background.  The use of suppressive antibiotics in treatment of orthopedic hardware infections (OHIs), including spinal hardware infections, prosthetic joint infections, and infections of internal fixation devices, is controversial. Methods.  Over a 4-year period at 2 academic medical centers, patients with OHI who were treated with debridement and retention of hardware components, with single-stage exchange, or without surgery were studied to determine whether use of oral antibiotics for at least 6 months after diagnosis impacts successful treatment of the infection at 1 year after diagnosis...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27745737/preoperative-antibiotic-prophylaxis-in-prosthetic-joint-infections-not-a-concern-for-intraoperative-cultures
#19
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Carlo Gamba, Pau Guirro, Santos Martínez-Díaz, Juan P Horcajada, Andrej Trampuz, Joan C Monllau
BACKGROUND: Culture negative prosthetic joint infections (PJI) still remain an issue even with the advantages of the new diagnostic tools for PJI. This is why some orthopedic surgeons have reservations relative to the use of preoperative antibiotic prophylaxis when a PJI is suspected. The purpose of the present study was to evaluate the influence of preoperative antibiotic prophylaxis on intraoperative cultures. MATERIAL AND METHODS: An enhanced diagnostic protocol for PJI (Zimmerli criteria) was used for the inclusion criteria in order to collect all PJI that were seen in a university hospital...
September 23, 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/27737642/outcome-of-patients-with-streptococcal-prosthetic-joint-infections-with-special-reference-to-rifampicin-combinations
#20
E Fiaux, M Titecat, O Robineau, J Lora-Tamayo, Y El Samad, M Etienne, N Frebourg, N Blondiaux, B Brunschweiler, F Dujardin, E Beltrand, C Loiez, V Cattoir, J P Canarelli, C Hulet, M Valette, S Nguyen, F Caron, H Migaud, E Senneville
BACKGROUND: Outcome of patients with streptococcal prosthetic joint infections (PJIs) is not well known. METHODS: We performed a retrospective multicenter cohort study that involved patients with total hip/knee prosthetic joint (THP/TKP) infections due to Streptococcus spp. from 2001 through 2009. RESULTS: Ninety-five streptococcal PJI episodes (50 THP and 45 TKP) in 87 patients of mean age 69.1 ± 13.7 years met the inclusion criteria...
October 13, 2016: BMC Infectious Diseases
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