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Arthroplasty infection staphylococcus.aureus

Michael P Palmer, Rachael Melton-Kreft, Laura Nistico, N Louisa Hiller, Leon H J Kim, Gregory T Altman, Daniel T Altman, Nicholas G Sotereanos, Fen Z Hu, Patrick J De Meo, Garth D Ehrlich
BACKGROUND: Preliminary studies have identified known bacterial pathogens in the knees of patients with osteoarthritis (OA) before arthroplasty. AIMS: The current study was designed to determine the incidence and types of bacteria present in the synovial fluid of native knee joints from adult patients with diagnoses of septic arthritis and OA. PATIENTS AND METHODS: Patients were enrolled between October 2010 and January 2013. Synovial fluid samples from the affected knee were collected and evaluated with both traditional microbial culture and polymerase chain reaction-electrospray ionization-time-of-flight mass spectrometry (molecular diagnostics [MDx]) to prospectively characterize the microbial content...
October 17, 2016: Genetic Testing and Molecular Biomarkers
A Deny, C Loiez, V Deken, S Putman, A Duhamel, J Girard, G Pasquier, C Chantelot, E Senneville, H Migaud
: Factors that predict the occurrence of a surgical site infection due to methicillin-resistant Staphylococcus aureus (MRSA) are not well known; however this information could be used to modify the recommended antimicrobial prophylaxis. We carried out a retrospective study of S. aureus infections on orthopedic implants to determine: (1) whether epidemiological factors can be identified that predict a MRSA infection, (2) the impact of these factors as evidenced by the odds ratio (OR). HYPOTHESIS: Risk factors for a MRSA infection can be identified from a cohort of patients with S...
October 12, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Valérie Zeller, Delphine Dedome, Luc Lhotellier, Wilfrid Graff, Nicole Desplaces, Simon Marmor
BACKGROUND: Concomitant infections of several prostheses are very rare, serious events that pose particular medical and surgical therapeutic challenges. This study was undertaken to describe epidemiologic, clinical, and microbiological characteristics of concomitant multiple joint arthroplasty infections, their treatments, and outcomes. METHODS: Retrospective (January 2000 and January 2014), single-center, cohort study in a referral center for bone and joint infections...
November 2016: Journal of Arthroplasty
Saiprasad Ravi, Mark Zhu, Christopher Luey, Simon W Young
BACKGROUND: Prophylactic antibiotics significantly reduce prosthetic joint infection (PJI) rates after hip and knee arthroplasty. However, rising antibiotic resistance has raised concerns over the adequacy of conventional prophylaxis. This study aimed to identify organisms causing PJIs in hip and knee arthroplasty secondary to perioperative contamination and their susceptibility to current prophylactic antibiotics. METHODS: We performed a retrospective audit of 4009 primary hip and knee arthroplasties (1852 hips and 2157 knees) at three tertiary referral hospitals...
August 25, 2016: ANZ Journal of Surgery
Tennison L Malcolm, Le Don Robinson, Alison K Klika, Deepak Ramanathan, Carlos A Higuera, Trevor G Murray
Protocols for the screening and decolonization of Staphylococcus aureus prior to total joint arthroplasty (TJA) have become widely adopted. The goals of this study were to determine: (1) whether implementation of a screening protocol followed by decolonization with mupirocin/vancomycin and chlorhexidine reduces the risk of revision compared with no screening protocol (i.e., chlorhexidine alone) and (2) whether clinical criteria could reliably predict colonization with MSSA and/or MRSA. Electronic medical records of primary patients undergoing TJA that were screened (n = 3,927) and were not screened (n = 1,751) for Staphylococcus aureus at least 4 days prior to surgery, respectively, were retrospectively reviewed...
2016: Interdisciplinary Perspectives on Infectious Diseases
Leo A Whiteside, M E Roy
BACKGROUND: Two-stage revision surgery for infected total hip arthroplasty (THA) is commonly advocated, but substantial morbidity and expense are associated with this technique. In certain cases of infected THA, treatment with one-stage revision surgery and intraarticular infusion of antibiotics may offer a reasonable alternative with the distinct advantage of providing a means of delivering the drug in high concentrations. QUESTIONS/PURPOSES: We describe a protocol for intraarticular delivery of antibiotics to the hip through an indwelling catheter combined with one-stage revision surgery and examine (1) the success as judged by eradication of infection at 1 year when treating chronically infected cemented stems; (2) success in treating late-onset acute infections in well-ingrown cementless stems; and (3) what complications were associated with this approach in a small case series...
August 10, 2016: Clinical Orthopaedics and related Research
J M Barbero, E Montero, A Vallés, M A Plasencia, J Romanyk, J Gómez
OBJECTIVE: Most publications about prosthetic joint infections (PJI) are referred to elective prosthesis and they exclude arthroplasties due to hip fracture. METHODS: We conducted a descriptive study about prosthetic joint infections after joint fracture in Alcalá de Henares Hospital (Madrid) between 2009 and 2014 and we compared with elective prosthetic infections in the same period. RESULTS: There were 30 PJI after hip fracture and 14 elective PJI...
October 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Scott M Sporer, Thea Rogers, Linda Abella
BACKGROUND: Deep infection after elective total joint arthroplasty remains a devastating complication. Preoperative nasal swab screening for Staphylococcus aureus colonization and subsequent treatment of colonized patients is one proposed method to identify at-risk patients and decrease surgical site infections (SSIs). The purpose of this study was to determine whether a preoperative staphylococcus screening and treatment program would decrease the incidence of SSI in elective joint arthroplasty patients...
September 2016: Journal of Arthroplasty
P N Streubel, J P Simone, B F Morrey, J Sanchez-Sotelo, M E Morrey
AIMS: We describe the use of a protocol of irrigation and debridement (I&D) with retention of the implant for the treatment of periprosthetic infection of a total elbow arthroplasty (TEA). This may be an attractive alternative to staged re-implantation. PATIENTS AND METHODS: Between 1990 and 2010, 23 consecutive patients were treated in this way. Three were lost to follow-up leaving 20 patients (21 TEAs) in the study. There were six men and 14 women. Their mean age was 58 years (23 to 76)...
July 2016: Bone & Joint Journal
Abdul Fettah Buyuk, Hakan Sofu, Ismet Yalkin Camurcu, Hanifi Ucpunar, Mehmet Akif Kaygusuz, Vedat Sahin
The main purpose of this study was to evaluate the clinical results of two-stage revision total knee arthroplasty using a teicoplanin-impregnated cement spacer for infected primary total knee replacements. Twenty-five patients operated between 2005 and 2012 were included in this study. At the clinical status analysis, rate of infection eradication was assessed, physical examination was performed, Knee Society Score (KSS) was noted, isolated microorganisms were recorded, and the radiographic evaluation was performed...
June 30, 2016: Journal of Knee Surgery
Matthew Thoendel, Patricio R Jeraldo, Kerryl E Greenwood-Quaintance, Janet Z Yao, Nicholas Chia, Arlen D Hanssen, Matthew P Abdel, Robin Patel
Metagenomic whole genome sequencing for detection of pathogens in clinical samples is an exciting new area for discovery and clinical testing. A major barrier to this approach is the overwhelming ratio of human to pathogen DNA in samples with low pathogen abundance, which is typical of most clinical specimens. Microbial DNA enrichment methods offer the potential to relieve this limitation by improving this ratio. Two commercially available enrichment kits, the NEBNext Microbiome DNA Enrichment Kit and the Molzym MolYsis Basic kit, were tested for their ability to enrich for microbial DNA from resected arthroplasty component sonicate fluids from prosthetic joint infections or uninfected sonicate fluids spiked with Staphylococcus aureus...
August 2016: Journal of Microbiological Methods
George Grammatopoulos, Mitsuru Munemoto, Yusuke Inagaki, Yasuhito Tanaka, Nicholas A Athanasou
BACKGROUND: Distinction of aseptic from septic hip arthroplasty failure can be challenging. Some studies report an increased incidence of septic failure with metal-on-metal (MoM) hip arthroplasties. The Musculoskeletal Infection Society (MSIS) have formulated criteria to facilitate the diagnosis of periprosthetic joint infection (PJI). In this study, we determined the prevalence and histologic features of septic MoM hip failure. METHODS: Overall, 104 cases of failed MoM hip arthroplasty, classified as septic or aseptic by MSIS microbiological criteria, were analyzed...
April 12, 2016: Journal of Arthroplasty
Cibele Zdebsky da Silva Pinto, Francine Taporosky Alpendre, Christiane Johnscher Niebel Stier, Eliane Cristina Sanches Maziero, Paulo Gilberto Cimbalista de Alencar, Elaine Drehmer de Almeida Cruz
OBJECTIVE: To characterize arthroplasty procedures, calculate the surgical infection rate and identify related risk factors. METHODS: This was a retrospective cohort study. Data on operations performed between 2010 and 2012 were gathered from documental sources and were analyzed with the aid of statistical software, using Fisher's exact test, Student's t test and the nonparametric Mann-Whitney and Wilcoxon tests. RESULTS: 421 total arthroplasty procedures performed on 346 patients were analyzed, of which 208 were on the knee and 213 on the hip...
November 2015: Revista Brasileira de Ortopedia
A E González-Vélez, M Romero-Martín, R Villanueva-Orbaiz, C Díaz-Agero-Pérez, A Robustillo-Rodela, V Monge-Jodra
OBJECTIVE: Surgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case-control study in acute-term care at Ramon y Cajal University Hospital in Spain. MATERIAL AND METHOD: Cases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network...
July 2016: Revista Española de Cirugía Ortopédica y Traumatología
Elissa Rennert-May, Kathryn Bush, David Vickers, Stephanie Smith
BACKGROUND: Knee and hip replacements are an effective intervention for improving quality of life. Rates of these surgeries in North America are growing, coinciding with increasing obesity and an aging population. METHODS: Alberta Health Services' infection prevention and control program collects data prospectively on surgical site infections (SSIs) after primary total hip and knee arthroplasty completed in Alberta, Canada. We reviewed all SSIs within 180 days of surgical procedures between March 1, 2012, and June 30, 2014...
May 6, 2016: American Journal of Infection Control
Joseph Bosco, Jared Bookman, James Slover, Emmanuel Edusei, Brett Levine
Infection is a rare, serious complication after total joint arthroplasty and constitutes a considerable emotional and financial burden for patients, surgeons, and healthcare systems. Prevention of surgical site and periprosthetic joint infections is crucial. This requires knowledge of the microorganisms that commonly cause these infections, including Staphylococcus species. Selection of the appropriate antibiotic regimen to treat infection remains controversial, but cefazolin and cefuroxime are the most commonly recommended antibiotics for prophylaxis...
2016: Instructional Course Lectures
Giovanni Balato, Tiziana Ascione, Massimo Mariconda, Pasquale Pagliano
A 73-year-old woman with rheumatoid arthritis presented to our institution with infection of her right total hip arthroplasty. On admission, a draining sinus tract over the hip and a palpable mass in the left lower posterior region of the neck were detected. The contrast CT scan showed a large abscess in the trapezius muscle and multiple abscesses involving muscle of the neck and right shoulder. Intraoperative specimens from the muscle abscess were positive for presumably the same methicillin-resistant Staphylococcus aureus that sustained the prosthetic joint infection...
2016: Le Infezioni in Medicina
Thomas Pommepuy, Adrien Lons, Kevin Benad, Eric Beltrand, Eric Senneville, Henri Migaud
Recommendations for the management of chronic and bilateral total hip arthroplasty (THA) infection are lacking. However, this type of infection involves medical problems concerning the management of the antibiotic therapy. We report two cases of such infections operated as one-stage revision. For each case, both hips were infected with the same bacteria (Staphylococcus caprae for one patient and methicillin-sensitive Staphylococcus aureus for the other). The probabilistic antibiotic treatment started during the first side (after harvesting intraoperative samples) did not prevent the culture of the bacteriologic harvested during the intervention of the second side...
2016: Case Reports in Orthopedics
Magnus Bergkvist, Sebastian S Mukka, Lars Johansson, Torbjörn E Ahl, Arkan S Sayed-Noor, Olof G Sköldenberg, Thomas Eisler
INTRODUCTION: Periprosthetic joint infection (PJI) is a devastating complication in hip arthroplasty surgery. Debridement, antibiotics (AB) and implant retention (DAIR) is recommended in early PJI in association with stable implants. The aim of this study was to evaluate the success rate of DAIR in early PJI (<4 weeks) and to identify factors predicting the outcome. METHODS: This cohort study included a consecutive series of 35 patients (median age 74 years, 25 women, 26 primary arthroplasties) treated with DAIR for an early PJI in a regional hospital...
March 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Dirk Zajonz, Almut Zieme, Torsten Prietzel, Michael Moche, Solveig Tiepoldt, Andreas Roth, Christoph Josten, Georg Freiherr von Salis-Soglio, Christoph-E Heyde, Mohamed Ghanem
BACKGROUND: Modular mega-endoprosthesis systems are used to bridge very large bone defects and have become a widespread method in orthopaedic surgery for the treatment of tumours and revision arthroplasty. However, the indications for the use of modular mega-endoprostheses must be carefully considered. Implanting modular endoprostheses requires major, complication-prone surgery in which the limited salvage procedures should always be borne in mind. The management of periprosthetic infection is particularly difficult and beset with problems...
2016: Patient Safety in Surgery
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