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Arthroplasty infection staphylococcus.aureus

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https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#1
Abtin Alvand, George Grammatopoulos, Floris de Vos, Matthew Scarborough, Ben Kendrick, Andrew Price, Roger Gundle, Duncan Whitwell, William Jackson, Adrian Taylor, Christopher L M H Gibbons
BACKGROUND: Endoprosthetic replacement (EPR) is an option for management of massive bone loss resulting from infection around failed lower limb implants. The aim of this study is to determine the mid-term outcome of EPRs performed in the treatment of periprosthetic joint infection (PJI) and infected failed osteosyntheses around the hip and knee joint and identify factors that influence it. METHODS: We retrospectively reviewed all hip and knee EPRs performed between 2007 and 2014 for the management of chronic infection following complex arthroplasty or fracture fixation...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29092997/the-orthopaedic-manifestation-and-outcomes-of-methicillin-sensitive-staphylococcus-aureus-septicaemia
#2
D Makki, T Elgamal, P Evans, D Harvey, G Jackson, S Platt
AIMS: The aim of this paper was to present the clinical features of patients with musculoskeletal sources of methicillin-sensitive Staphylococcus aureus (MSSA) septicaemia. PATIENTS AND METHODS: A total of 137 patients presented with MSSA septicaemia between 2012 and 2015. The primary source of infection was musculoskeletal in 48 patients (35%). Musculoskeletal infection was considered the primary source of septicaemia when endocarditis and other obvious sources were excluded...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29089192/use-of-surveillance-data-to-calculate-the-sample-size-and-the-statistical-power-of-randomized-clinical-trials-testing-staphylococcus-aureus-vaccine-efficacy-in-orthopedic-surgery
#3
Marie-Paule Gustin, Robin Ohannessian, Marine Giard, Emmanuelle Caillat-Vallet, Anne Savey, Philippe Vanhems
BACKGROUND: Patients undergoing primary total hip arthroplasty (THA) would be a worthy population for anti-staphylococcal vaccines. The objective is to assess sample size for significant vaccine efficacy (VE) in a randomized clinical trial (RCT). METHODS: Data from a surveillance network of surgical site infection in France between 2008 and 2011 were used. The outcome was S. aureus SSI (SASSI) within 30 days after surgery. Statistical power was estimated by simulations repeated for theoretical VE ranging from 20% to 100% and for sample sizes from 250 to 8000 individuals per arm...
October 28, 2017: Vaccine
https://www.readbyqxmd.com/read/29040128/single-dose-preoperative-vitamin-d-supplementation-decreases-infection-in-a-mouse-model-of-periprosthetic-joint-infection
#4
Vishal Hegde, Erik M Dworsky, Alexandra I Stavrakis, Amanda H Loftin, Stephen D Zoller, Howard Y Park, Sherif Richman, Daniel Johansen, Yan Hu, Julie A Taylor, Christopher D Hamad, Rene F Chun, Weixian Xi, John S Adams, Nicholas M Bernthal
BACKGROUND: Despite recent advances, infection remains the most common etiology of arthroplasty failure. Recent work suggests that 25-hydroxyvitamin D (25D) deficiency correlates with the frequency of periprosthetic joint infection (PJI). We endeavored to examine whether 25D3 deficiency leads to increased bacterial burden in vivo in an established mouse model of PJI and, if so, whether this effect can be reversed by preoperative 25D3 supplementation. METHODS: Mice (lys-EGFP) possessing fluorescent neutrophils were fed a vitamin D3-sufficient (n = 20) or deficient (n = 40) diet for 6 weeks...
October 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28988937/temporal-trends-and-epidemiology-of-staphylococcus-aureus-surgical-site-infection-in-the-swiss-surveillance-network-a-cohort-study
#5
Mohamed Abbas, Emin Aghayev, Nicolas Troillet, Marie-Christine Eisenring, Stefan P Kuster, Andreas F Widmer, Stephan Harbarth
BACKGROUND: Staphylococcus aureus is the leading pathogen in surgical site infections (SSIs). AIM: To explore trends and risk factors associated with S. aureus SSI. METHODS: We identified risk factors for monomicrobial S. aureus SSI from the Swiss multi-centre SSI surveillance system using multivariate logistic regression. Both in-hospital and post-discharge SSIs were identified using standardized definitions. FINDINGS: Over a 6 year period, we collected data on 229,765 surgical patients, of whom 499 (0...
October 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28983214/factors-associated-with-choice-and-success-of-one-versus-two-stage-revision-arthroplasty-for-infected-hip-and-knee-prostheses
#6
Lucas Castellani, Nick Daneman, Samira Mubareka, Richard Jenkinson
BACKGROUND: Prosthetic joint infections (PJI) of hip and knee arthroplasties are becoming increasingly common with an aging population and an increasing demand for these procedures. Despite attempts at standardization, medical and surgical approaches vary widely among practitioners. QUESTIONS/PURPOSES: We first sought to determine if there were specific factors associated with choice of one- versus two-stage revision. Then we investigated whether the type of revision approach influenced clinical treatment success...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28967053/multifaceted-aseptic-protocol-decreases-surgical-site-infections-following-hip-arthroplasty
#7
Ryan E Harold, Bennet A Butler, Joseph Lamplot, Hue H Luu, Cort D Lawton, David Manning
INTRODUCTION: We investigate the effectiveness of a comprehensive aseptic protocol in reducing surgical site infection (SSI) after hip arthroplasty in a single medical centre with a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA). METHODS: A prospectively collected database of all patients undergoing hip arthroplasty in a single centre between 2005 and 2011 was reviewed for SSI using Centers for Disease Control (CDC) criteria and AAOS guidelines...
September 21, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28930833/readmission-due-to-infection-following-total-hip-and-total-knee-procedures-a-retrospective-study
#8
Nadine Zawadzki, Yao Wang, Hui Shao, Emelline Liu, Chao Song, Michele Schoonmaker, Lizheng Shi
Policymakers have expanded readmissions penalty programs to include elective arthroplasties, but little is known about the risk factors for readmissions following these procedures. We hypothesized that infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA) lead to excess readmissions and increased costs. This study aims to evaluate the proportion of readmissions due to infections following THA and TKA.Healthcare Cost and Utilization Project-State Inpatient Databases were used for the study...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28860394/does-tantalum-exhibit-any-intrinsic-antimicrobial-or-antibiofilm-properties
#9
P L Harrison, T Harrison, I Stockley, T J Smith
AIMS: Tantalum (Ta) trabecular metal components are increasingly used to reconstruct major bone defects in revision arthroplasty surgery. It is known that some metals such as silver have antibacterial properties. Recent reports have raised the question regarding whether Ta components are protective against infection in revision surgery. This laboratory study aimed to establish whether Ta has intrinsic antibacterial properties against planktonic bacteria, or the ability to inhibit biofilm formation...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28842287/determining-potential-of-pmma-as-a-depot-for-rifampin-to-treat-recalcitrant-orthopaedic-infections
#10
Stefanie M Shiels, David J Tennent, Kevin S Akers, Joseph C Wenke
BACKGROUND: Open fractures are often complicated by infection. In cases of severe soft tissue and vascular injury, systemic antibiotics may be ineffective due to their inability to reach and provide direct antimicrobial activity to the zone of injury. High antibiotic concentrations within the wound can be achieved with reduced systemic toxicity by using local antibiotic delivery. As bacteria associated with musculoskeletal injuries frequently form biofilms, antibiotic selection is important...
August 16, 2017: Injury
https://www.readbyqxmd.com/read/28773989/bacterial-infection-and-implant-loosening-in-hip-and-knee-arthroplasty-evaluation-of-209-cases
#11
Ulrike Dapunt, Stephanie Radzuweit-Mihaljevic, Burkhard Lehner, Gertrud Maria Haensch, Volker Ewerbeck
The aim of this study was to evaluate bacteria species detected in a large number of patients treated for prosthetic joint infection of the hip and knee at a single specialized center. Furthermore, the rate of implant loosening was investigated in a time-dependent manner for the most frequently detected bacteria species. A retrospective analysis of patients (n = 209) treated for prosthetic joint infection of the hip and knee was performed. The following parameters were evaluated: C-Reactive Protein (CRP) concentration, microbiological evaluation of tissue samples, loosening of the implant, the time that had elapsed since the primary prosthetic joint replacement, and the duration since the last surgical intervention...
October 26, 2016: Materials
https://www.readbyqxmd.com/read/28739308/risk-of-surgical-site-infection-in-elective-hip-and-knee-replacements-after-confirmed-eradication-of-mrsa-in-chronic-carriers
#12
Tarang Tandon, Baha J Tadros, Harold Akehurst, Adhish Avasthi, Richard Hill, Madhu Rao
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is globally endemic and is a leading cause of surgical site infection (SSI). The purpose of this study was to evaluate the incidence of SSI in MRSA carriers undergoing elective hip or knee arthroplasty, who had confirmed eradication and to compare it with incidence of SSI in non-MRSA carriers. METHODS: This is a retrospective analysis of 6613 patients who underwent elective total hip arthroplasty (THA; n = 3347) and total knee arthroplasty (TKA; n = 3266) at our institution...
December 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28691647/microbiological-diagnosis-in-revision-of-infected-knee-arthroplasties-in-denmark
#13
Martin Lindberg-Larsen, Frederik T Pitter, Marianne Voldstedlund, Henrik M Schrøder, Jens Bagger
BACKGROUND: Revision of infected knee arthroplasties is associated with high failure rates (30-40%). An understanding of the microbiology is important to optimize treatment and outcome. We describe microbiological diagnostic practice and diagnosis in revision of infected knee arthroplasties. METHODS: One hundred and two partial revisions (open debridement and exchange of tibial insert) and 213 two-stage procedures performed due to infection in 275 patients from 1 July 2011 to 30 June 2013 were included and analysed by linkage to data from a nationwide registry on microbiological test results...
July 8, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28690040/bioactivity-of-ceftazidime-and-fluconazole-included-in-polymethyl-methacrylate-bone-cement-for-use-in-arthroplasty
#14
J Martínez-Moreno, V Merino, A Nácher, J L Rodrigo, Blanca B Bonet Yuste, M Merino-Sanjuán
BACKGROUND: The microorganisms that most frequently cause prosthetic joint infection are methicillin-resistant Staphylococcus aureus and gram-negative aerobic bacillus. Studies have documented the efficacy of mixing antibiotics with polymethyl methacrylate, but that of antifungal drugs has not received much attention. The objective of this in vitro study was to characterize the elution profile and bioactivity of ceftazidime and fluconazole when incorporated into bone cement in proportions intended for prophylaxis and treatment of bone infections...
May 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28585795/-decolonization-for-staphylococcus-aureus-carriers-in-arthroplasty-surgery-after-hip-fracture
#15
J M Barbero, J Romanyk, A Vallés, M A Plasencia, E Montero, J López
OBJECTIVE: Staphylococcus aureus is the main causative agent of joint prosthesis infections. The decolonization of the carriers is effective in the prevention of the infections of the elective arthroplasties. The aim of this study is to evaluate if it is also in arthroplasties after hip fracture. METHODS: Study in patients with hip fracture who underwent joint prosthesis from January 2011 to December 2015 with a protocol of S. aureus detection-decolonization with intranasal mupirocin and chlorhexidine baths...
June 5, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28578841/povidone-iodine-based-solutions-for-decolonization-of-nasal-staphylococcus-aureus-a-randomized-prospective-placebo-controlled-study
#16
Maryam Rezapoor, Thema Nicholson, Reza Mostafavi Tabatabaee, Antonia F Chen, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Nasal Staphylococcus aureus decolonization reduces the risk of surgical site infections after orthopedic procedures. Povidone-iodine (PI)-based solutions have shown promising results in bacteria decolonization. The unique physiology of the nose may pose challenges for the bioactivity profiles of PI solutions. This study compared the antibacterial efficacy of an off-the-shelf PI product with a specifically manufactured PI-based skin and nasal antiseptic (SNA). METHODS: This randomized, placebo-controlled study was conducted at a single institution between April 2014 and July 2015...
May 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28461965/total-knee-arthroplasty-and-infection-how-surgeons-can-reduce-the-risks
#17
REVIEW
Nicola Ratto, Chiara Arrigoni, Federica Rosso, Matteo Bruzzone, Federico Dettoni, Davide Edoardo Bonasia, Roberto Rossi
Total joint arthroplasty (TJA) is one of the most common orthopaedic procedures. Nevertheless, several complications can lead to implant failure.Peri-prosthetic joint infections (PJI) certainly represent a significant challenge in TJA, constituting a major cause of prosthetic revision. The surgeon may have an important role in reducing the PJI rate by limiting the impact of significant risk factors associated to either the patient, the operative environment or the post-operative care.In the pre-operative period, several preventive measures may be adopted to manage reversible medical comorbidities...
September 2016: EFORT open reviews
https://www.readbyqxmd.com/read/28448204/future-research-opportunities-in-peri-prosthetic-joint-infection-prevention
#18
Elie Berbari, John Segreti, Javad Parvizi, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28434697/poor-outcomes-of-irrigation-and-debridement-in-acute-periprosthetic-joint-infection-with-antibiotic-impregnated-calcium-sulfate-beads
#19
Michael A Flierl, Brian M Culp, Kamil T Okroj, Bryan D Springer, Brett R Levine, Craig J Della Valle
BACKGROUND: One proposed strategy to increase the success of irrigation and debridement with implant retention for the treatment of acute periprosthetic joint infection (PJI) is the use of dissolvable antibiotic-impregnated calcium sulfate beads to provide a local depot of antibiotics. The purpose of this study was to evaluate the outcome of such an approach. METHODS: Thirty-two patients with acute hematogenous (18 patients; 1 bilateral) or acute postoperative (14 patients) PJIs who underwent irrigation and debridement with implant retention and addition of antibiotic-impregnated calcium sulfate beads were retrospectively reviewed...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#20
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
July 2017: Clinical Orthopaedics and related Research
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