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Arthroplasty infection staphylococcus.aureus

K Clesham, P Ryan, C Murphy
Prosthetic joint infection (PJI) is a devastating complication of arthroplasty. Numerous protocols reduce potential risk for PJI peri-operatively, but none exist for the management of theatre shoes. Our aim was to assess for bacteria known to cause prosthetic infection on theatre shoes. Forty theatre shoes were analysed; there were coagulase-negative staphylococci on 65% (N = 25), meticillin-susceptible Staphylococcus aureus on 40% (N = 16), and meticillin-resistant S. aureus on 25% (N = 10). Amount of blood spatter correlated poorly with microbial contamination...
March 16, 2018: Journal of Hospital Infection
Ahmed Siddiqi, Nicole E George, Peter B White, Bartlomiej W Szczech, John V Thompson, Jennifer I Etcheson, Chukwuweike U Gwam, Alexander T Caughran, Ronald E Delanois, James Nace
INTRODUCTION: Periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) is a challenging complication for surgeons and patients alike. Although two-stage revision arthroplasty remains the gold standard PJI management in the United States, one-stage revision has had success in many parts of Europe. The aim of this study was to retrospectively review: 1) ultimate treatment success; 2) necessary antibiotic duration; 3) change in knee range of motion (ROM); and 4) final Knee Society Scores (KSS) in a case series of patients managed with retention of articulating antibiotic spacers following PJI...
March 12, 2018: Surgical Technology International
Kevin L Garvin, Ryan E Miller, Todd M Gilbert, Anthony M White, Elizabeth R Lyden
BACKGROUND: Two-stage reimplantation has consistently yielded high rates of success for patients with chronic prosthetic joint infection, although results more than 5 years after reimplantation are not commonly reported. Numerous factors may contribute to the risk of reinfection, although these factors-as well as the at-risk period after reimplantation-are not well characterized. QUESTIONS/PURPOSES: (1) What is the risk of reinfection after reimplantation for prosthetic joint infection at a minimum of 5 years? (2) Is the bacteriology of the index infection associated with late reinfection? (3) Is the presence of bacteria at the time of reimplantation associated with late reinfection? METHODS: Between 1995 and 2010, we performed 97 two-stage revisions in 93 patients for prosthetic joint infection of the hip or knee, and all are included in this retrospective study...
February 2018: Clinical Orthopaedics and related Research
Yehuda E Kerbel, Anisha R Sunkerneni, Gregory J Kirchner, John P Prodromo, Vincent M Moretti
BACKGROUND: This article presents a break-even analysis for preoperative Staphylococcus aureus colonization screening and decolonization protocols in total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: Protocol costs, baseline infection rates after arthroplasty, and average revision costs were obtained from institutional records and the literature. The break-even analysis determined the absolute risk reduction (ARR) in infection rate required for cost-effectiveness...
January 31, 2018: Journal of Arthroplasty
G Ryan Rieser, Joseph T Moskal
BACKGROUND: With increasing rates of virulent drug resistant organisms, MRSA (methicillin-resistant Staphylococcus aureus) decolonization has been demonstrated to decrease infection rates. Recent research has shown the antiseptic povidone-iodine to be equally effective and potentially cost saving compared to intranasal mupirocin. This study's purpose is to evaluate the incidence of MRSA colonization in a more rural community-based population, rates of infection on a mupirocin decolonization protocol, and develop a cost analysis model to compare costs of utilizing povidone-iodine...
January 31, 2018: Journal of Arthroplasty
Will B J Rudge, Kelechi Eseonu, Matthew Brown, Simon Warren, Addie Majed, Ian L Bayley, Simon M Lambert, Deborah Higgs, Mark Falworth
BACKGROUND: Deep prosthetic infection is a potentially devastating complication after total elbow arthroplasty, with an incidence of up to 12%. This study examined the demographics, microbiologic profile, and outcomes of infected total elbow arthroplasty treated with 2-stage revision in a tertiary referral unit. METHODS: We identified 19 consecutive patients (mean age, 65 years) undergoing revision arthroplasty for deep prosthetic infection. All patients underwent a first-stage procedure with removal of implants, débridement, and insertion of an antibiotic-loaded cement spacer, followed by at least 6 weeks of intravenous antibiotics...
March 1, 2018: Journal of Shoulder and Elbow Surgery
Jaiben George, Jared M Newman, Alison K Klika, Evan M Miller, Timothy L Tan, Javad Parvizi, Carlos A Higuera
BACKGROUND: Staphylococcus aureus is the predominant cause of periprosthetic joint infection (PJI) and can persist at the time of planned second stage of 2-stage revision arthroplasty, despite antibiotic cement spacer insertion and parenteral antibiotic therapy. Given the rapid emergence of antibiotic resistance, it is important to determine whether the antibiotic susceptibility of microorganisms changes between the stages of a 2-stage revision. METHODS: A total of 1614 2-stage revision hip/knee arthroplasties performed for PJI at 2 academic institutions from 2000 to 2015 were identified...
March 1, 2018: Journal of Arthroplasty
Franz Müller, Michael Galler, Christina Roll, Bernd Füchtmeier
Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Amanda L Walsh, Adam C Fields, James D Dieterich, Darwin D Chen, Michael J Bronson, Calin S Moucha
BACKGROUND: Several studies have shown that Staphylococcus aureus (S aureus) nasal colonization is associated with surgical site infection and that preoperative decolonization can reduce infection rates. Up to 30% of joint arthroplasty patients have positive S aureus nasal swabs. Patient risk factors for colonization remain largely unknown. The aim of this study was to determine whether there is a specific patient population at increased risk of S aureus nasal colonization. METHODS: This study is a retrospective review of 716 patients undergoing hip or knee arthroplasty beginning in 2011...
December 29, 2017: Journal of Arthroplasty
Xin-Yu Fang, Wen-Bo Li, Chao-Fan Zhang, Zi-da Huang, Hui-Yi Zeng, Zheng Dong, Wen-Ming Zhang
OBJECTIVE: To explore the diagnostic efficiency of DNA-based and RNA-based quantitative polymerase chain reaction (qPCR) analyses for periprosthetic joint infection (PJI). METHODS: To determine the detection limit of DNA-based and RNA-based qPCR in vitro, Staphylococcus aureus and Escherichia coli strains were added to sterile synovial fluid obtained from a patient with knee osteoarthritis. Serial dilutions of samples were analyzed by DNA-based and RNA-based qPCR...
January 30, 2018: Orthopaedic Surgery
S T J Tsang, M P McHugh, D Guerendiain, P J Gwynne, J Boyd, A H R W Simpson, T S Walsh, I F Laurenson, K E Templeton
OBJECTIVES: Nasal carriers of Staphylococcus (S.) aureus ( MRSA and MSSA ) have an increased risk for healthcare-associated infections. There are currently limited national screening policies for the detection of S. aureus despite the World Health Organization's recommendations. This study aimed to evaluate the diagnostic performance of molecular and culture techniques in S. aureus screening, determine the cause of any discrepancy between the diagnostic techniques, and model the potential effect of different diagnostic techniques on S...
January 2018: Bone & Joint Research
David Sadigursky, Henrique Santos Pires, Saulo Américo Caldas Rios, Francisco Luiz Borja Rodrigues Filho, Gustavo Castro de Queiroz, Mateus Lemos Azi
Despite the evolution of the total knee and hip arthroplasty surgery, high postoperative complication rates in the short and long term still persist. Infection is one of the most challenging complications; due to its gravity and treatment difficulties, prophylaxis protocols have been created to decrease its incidence. The objective of this study was to evaluate the impact of the prophylaxis protocol for methicillin-resistant Staphylococcus aureus decolonization of the nares in patients previously identified by swab cultures, who were to be submitted to a total joint arthroplasty...
November 2017: Revista Brasileira de Ortopedia
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
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
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...
December 15, 2017: Vaccine
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
M Abbas, E Aghayev, N Troillet, M-C Eisenring, S P Kuster, A F Widmer, S Harbarth
BACKGROUND: Staphylococcus aureus is the leading pathogen in surgical site infections (SSI). AIM: To explore trends and risk factors associated with S. aureus SSI. METHODS: Risk factors for monomicrobial S. aureus SSI were identified from the Swiss multi-centre SSI surveillance system using multi-variate logistic regression. Both in-hospital and postdischarge SSI were identified using standardized definitions. FINDINGS: Over a six-year period, data were collected on 229,765 surgical patients, of whom 499 (0...
February 2018: Journal of Hospital Infection
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
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
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)
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