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Arthroplasty infection staphylococcus.aureus

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https://www.readbyqxmd.com/read/28316961/acute-delayed-or-late-infection-of-revision-total-hip-arthroplasty-treated-with-debridement-antibiotic-loaded-cement-beads-and-retention-of-the-prosthesis
#1
Jun-Dong Chang, In-Sung Kim, Sang-Soo Lee, Je-Hyun Yoo
PURPOSE: The treatment of infected revision total hip arthroplasty (THA) is very challenging due to retained revision prosthesis, poor bone stock and soft tissue condition derived from previous revision surgeries, and comorbidities. The purpose of this study was to investigate the effectiveness and short-term outcomes of aggressive debridement and use of antibiotic-loaded cement beads with retention of the prosthesis for acute delayed or late infection of revision THAs. MATERIALS AND METHODS: Ten consecutive patients with symptoms or signs of less than one-week evolution and well-fixed prostheses, were treated with this procedure and a postoperative course of organism-specific antibiotics for a minimum of 6 weeks...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28291188/quantification-of-peri-implant-bacterial-load-and-in-vivo-biofilm-formation-in-an-innovative-clinically-representative-mouse-model-of-periprosthetic-joint-infection
#2
Alberto V Carli, Samrath Bhimani, Xu Yang, Matthew B Shirley, Karen L de Mesy Bentley, F Patrick Ross, Mathias P G Bostrom
BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication following total joint arthroplasty. Current animal models of PJI are limited because of a lack of quantitative methods and failure to effectively recreate the periprosthetic space. We therefore developed a murine PJI model involving a 3-dimensionally printed Ti-6Al-4V implant capable of bearing weight and permitting quantitative analysis of periprosthetic bacterial load and evaluation of biofilm. METHODS: Twenty-five 12-week-old C57BL/6 mice received a unilateral proximal tibial implant and intra-articular injection of either 3 × 10 colony forming units (CFUs) of Staphylococcus aureus Xen 36 or saline solution...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#3
REVIEW
Adam C Rothenberg, Alan E Wilson, John P Hayes, Michael J O'Malley, Brian A Klatt
BACKGROUND: There is evidence that sonication of explanted prosthetic hip and knee arthroplasty components with culture of the sonication fluid may enhance diagnostic sensitivity. Previous studies on the use of implant sonicate cultures have evaluated diagnostic thresholds but did not elaborate on the clinical importance of positive implant sonicate cultures in the setting of presumed aseptic revisions and did not utilize consensus statements on periprosthetic joint infection (PJI) diagnosis when defining their gold standard for infection...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28271919/prosthetic-joint-infection-a-devastating-complication-of-hemiarthroplasty-for-hip-fracture
#4
Ellen Guren, Wender Figved, Frede Frihagen, Leiv Otto Watne, Marianne Westberg
Background and purpose - Hemiarthroplasty is the most common treatment in elderly patients with displaced femoral neck fracture. Prosthetic joint infection (PJI) is a feared complication. The infection rate varies in the literature, and there are limited descriptive data available. We investigated the characteristics and outcome of PJI following hemiarthroplasty over a 15-year period. Patients and methods - Patients with PJI were identified among 519 patients treated with hemiarthroplasty for a femoral neck fracture at Oslo University Hospital between 1998 and 2012...
March 8, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28249976/bone-penetration-of-intravenous-flucloxacillin-and-gentamicin-as-antibiotic-prophylaxis-during-total-hip-and-knee-arthroplasty
#5
M S Torkington, M J Davison, E F Wheelwright, P J Jenkins, I Anthony, A M Lovering, M Blyth, B Jones
AIMS: To investigate the bone penetration of intravenous antibiotic prophylaxis with flucloxacillin and gentamicin during hip and knee arthroplasty, and their efficacy against Staphylococcus (S.) aureus and S. epidermidis. PATIENTS AND METHODS: Bone samples from the femoral head, neck and acetabulum were collected from 18 patients undergoing total hip arthroplasty (THA) and from the femur and tibia in 21 patients during total knee arthroplasty (TKA). The concentration of both antibiotics in the samples was analysed using high performance liquid chromatography...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28222919/specific-infectious-organisms-associated-with-poor-outcomes-in-treatment-for-hip-periprosthetic-infection
#6
Daniel J Cunningham, Joseph J Kavolus, Michael P Bolognesi, Samuel S Wellman, Thorsten M Seyler
BACKGROUND: Periprosthetic hip infection treatment remains a significant challenge for orthopedics. Some studies have suggested that methicillin resistance and gram-negative organism type are associated with increased treatment failure. The aim of this research is to determine if specific organisms were associated with poor outcomes in treatment for hip periprosthetic infection. METHODS: Records were reviewed of all patients between 2005 and 2015 who underwent treatment for infected partial or total hip arthroplasty...
January 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28162880/surgical-management-of-periprosthetic-shoulder-infections
#7
Geoffrey P Stone, Rachel E Clark, Kathleen C O'Brien, Lisa Vaccaro, Peter Simon, Adam J Lorenzetti, Brent C Stephens, Mark A Frankle
BACKGROUND: The treatment of periprosthetic joint infection is a difficult challenge in shoulder arthroplasty. This study investigated 1-stage modular component exchange vs. 1-stage complete removal and reimplantation (CRR) vs. 2-stage revision arthroplasty for periprosthetic joint infection. METHODS: Between January 1, 2004, and December 31, 2012, 79 patients received a component exchange (n = 15), CRR (n = 45), or a 2-stage (n = 19) revision for infection. A binary logistic regression analysis was performed to determine factors presenting the greatest risk of reinfection...
February 2, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28145954/intra-articular-vancomycin-powder-eliminates-methicillin-resistant-s-aureus-in-a-rat-model-of-a-contaminated-intra-articular-implant
#8
Adam I Edelstein, Joseph A Weiner, Ralph W Cook, Danielle S Chun, Emily Monroe, Sean M Mitchell, Abhishek Kannan, Wellington K Hsu, S David Stulberg, Erin L Hsu
BACKGROUND: Periprosthetic joint infection following hip and knee arthroplasty leads to poor outcomes and exorbitant costs. Topical vancomycin powder has been shown to decrease infection in many procedures such as spine surgery. The role of vancomycin powder in the setting of total joint arthroplasty remains undefined. Our aim was to evaluate the efficacy of intra-articular vancomycin powder in preventing infection in a rat model of a contaminated intra-articular implant. METHODS: Thirty-two female Sprague-Dawley rats underwent knee arthrotomy and implantation of a femoral intramedullary wire with 1 mm of intra-articular communication...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28116254/bilateral-prosthetic-hip-joint-infections-associated-with-a-psoas-abscess-a-case-report
#9
G D Rajitha Gunaratne, Riaz J K Khan, Cynthia Tan, Clayton Golledge
INTRODUCTION: Psoas abscess is a recognized but under-diagnosed complication of prosthetic hip joint infections. CASE REPORT: We report a case of a 68-year-old man with right and left hip arthroplasties performed 22 and 14 years ago, respectively, who presented with non-specific symptoms and was subsequently diagnosed with left psoas abscess on CT scan. Drainage of the psoas abscess was complicated by the formation of a discharging sinus connected to the left hip...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28032700/management-of-acute-hematogenous-infection-following-total-knee-arthroplasty-a-case-series-of-11-patients
#10
Rui He, Liu Yang, Lin Guo, Hao Chen, Ying Zhang, Dian-Ming Jiang
OBJECTIVE: Acute hematogenous infection is a devastating complication that can occur after total knee arthroplasty (TKA). The best strategies for management of this infection remain controversial. Two-stage revision has been well described as the gold standard for the management of chronic late infections. However, there is a paucity of information presently available on the management and outcomes of patients treated for acute hematogenous infections. The purpose of the present study was to report the outcome of acute hematogenous infections following TKA with the treatment of irrigation, debridement, and retention of the prosthetic components...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27986623/one-year-incidence-of-prosthetic-joint-infection-in-total-hip-arthroplasty-a-cohort-study-with-linkage-of-the-danish-hip-arthroplasty-register-and-danish-microbiology-databases
#11
P H Gundtoft, A B Pedersen, H C Schønheyder, J K Møller, S Overgaard
OBJECTIVE: To examine the trend of Prosthetic Joint Infections (PJI) following primary total hip arthroplasty (THA) and the antimicrobial resistance of the bacteria causing these infections. MATERIALS AND METHODS: We identified a population-based cohort of patients in the Danish Hip Arthroplasty Register (DHR) who had primary THA and received their surgery in Jutland or Funen between 2005 and 2014. We followed the patients until revision, emigration, death, or up to 1-year of follow-up...
December 13, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/27980378/operating-room-environment-and-surgical-site-infections-in-arthroplasty-procedures
#12
REVIEW
M L Cristina, M Sartini, E Schinca, G Ottria, A M Spagnolo
BACKGROUND: The rate of surgical site infections (SSI) is strongly influenced by operating room quality, which is determined by the structural features of the facility and its systems and by the management and behavior of healthcare workers. The aim of the present study was to assess microbial contamination in the operating room during hip- and knee-replacement procedures, the behavior of operating room staff and the incidence of SSI through postdischarge surveillance. METHODS: Microbial contamination was evaluated by active and passive sampling at rest and in operating conditions...
September 2016: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/27919672/a-study-of-pre-operative-presence-of-micro-organisms-in-affected-knee-joints-of-rheumatoid-arthritis-patients-who-need-total-knee-arthroplasty
#13
Jiang-Ming Luo, Lin Guo, Hao Chen, Peng-Fei Yang, Ran Xiong, Yang Peng, Liu Yang
BACKGROUND: To evaluate, by way of intraoperative tissue culture and pathological study, the pre-operative presence of micro-organisms in knee joints of patients with rheumatoid arthritis (RA) who need total knee arthroplasty (TKA). METHODS: From November 2012 to January 2014, 47 patients with RA (53 knees) who needed TKA were included in this study. Patients received routine pre-operative examination and joint fluid routine and culture. Each RA patient was match-paired with one osteoarthritis (OA) patient...
December 2, 2016: Knee
https://www.readbyqxmd.com/read/27890730/cathodic-voltage-controlled-electrical-stimulation-of-titanium-for-prevention-of-methicillin-resistant-staphylococcus-aureus-and-acinetobacter-baumannii-biofilm-infections
#14
Mary Canty, Nicole Luke-Marshall, Anthony Campagnari, Mark Ehrensberger
Antibiotic resistance of bacterial biofilms limits available treatment methods for implant-associated orthopaedic infections. This study evaluated the effects of applying cathodic voltage-controlled electrical stimulations (CVCES) of -1.5V and -1.8V (vs. Ag/AgCl) to coupons of commercially pure titanium (cpTi) incubated in cultures of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii (A. baumannii) as a method of preventing bacterial attachment. Stimulations were applied for 2, 4, and 8h and coupon-associated and planktonic colony-forming units (CFU) were enumerated following stimulation...
November 24, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27876465/is-there-still-a-role-for-irrigation-and-debridement-with-liner-exchange-in-acute-periprosthetic-total-knee-infection
#15
Andrés F Duque, Zachary D Post, Rex W Lutz, Fabio R Orozco, Sergio H Pulido, Alvin C Ong
BACKGROUND: Periprosthetic joint infection (PJI) is an important cause of failure in total knee arthroplasty. Irrigation and debridement including liner exchange (I&D/L) success rates have varied for acute PJI. The purpose of this study is to present results of a specific protocol for I&D/L with retention of total knee arthroplasty components. METHODS: Sixty-seven consecutive I&D/L patients were retrospectively evaluated. Inclusion criteria for I&D/L were as follows: fewer than 3 weeks of symptoms, no immunologic compromise, intact soft tissue sleeve, and well-fixed components...
November 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27844159/clinical-and-epidemiological-differences-between-implant-associated-and-implant-free-orthopaedic-infections
#16
Céline Cuérel, Sophie Abrassart, Julien Billières, Diego Andrey, Domizio Suva, Victor Dubois-Ferrière, Ilker Uçkay
PURPOSE: Although there have been many publications regarding the risk factors for implant-associated orthopaedic infections, none have investigated how clinical presentations and epidemiology may differ between infections with and without osteosynthetic material. METHODS: We pooled clinical data from several databases of adult patients with orthopaedic infections hospitalized at Geneva University Hospitals from January 2004 to December 2014. RESULTS: Among 2740 episodes of orthopaedic infections, 76% were implant-free osteoarticular or soft tissue infections...
February 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27834161/periprosthetic-infection-following-primary-hip-and-knee-arthroplasty-the-impact-of-limiting-the-postoperative-surveillance-period
#17
Virginia R Roth, Robyn Mitchell, Julie Vachon, Stéphanie Alexandre, Kanchana Amaratunga, Stephanie Smith, Mary Vearncombe, Ian Davis, Dominik Mertz, Elizabeth Henderson, Michael John, Lynn Johnston, Camille Lemieux, Linda Pelude, Denise Gravel
BACKGROUND Hip and knee arthroplasty infections are associated with considerable healthcare costs. The merits of reducing the postoperative surveillance period from 1 year to 90 days have been debated. OBJECTIVES To report the first pan-Canadian hip and knee periprosthetic joint infection (PJI) rates and to describe the implications of a shorter (90-day) postoperative surveillance period. METHODS Prospective surveillance for infection following hip and knee arthroplasty was conducted by hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP) using standard surveillance definitions...
February 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27832042/prior-staphylococcus-aureus-nasal-colonization-a-risk-factor-for-surgical-site-infections-following-decolonization
#18
Nicholas Ramos, Anna Stachel, Michael Phillips, Jonathan Vigdorchik, James Slover, Joseph A Bosco
INTRODUCTION: Staphylococcus aureus (S aureus) decolonization regimens are being used to mitigate the risk of surgical site infection (SSI). However, their efficacy is controversial, with mixed results reported in the literature. METHODS: Before undergoing primary total knee arthroplasty (TKA), total hip arthroplasty (THA), or spinal fusion, 13,828 consecutive patients were screened for nasal S aureus and underwent a preoperative decolonization regimen. Infection rates of colonized and noncolonized patients were compared using unadjusted logistic regression...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27823845/decreased-hospital-costs-and-surgical-site-infection-incidence-with-a-universal-decolonization-protocol-in-primary-total-joint-arthroplasty
#19
Jeffrey B Stambough, Denis Nam, David K Warren, James A Keeney, John C Clohisy, Robert L Barrack, Ryan M Nunley
BACKGROUND: Staphylococcus aureus colonization has been identified as a key modifiable risk factor in the reduction of surgical site infections (SSI) related to elective total joint arthroplasty (TJA). We investigated the incidence of SSIs and cost-effectiveness of a universal decolonization protocol without screening consisting of nasal mupirocin and chlorhexidine before elective TJA compared to a program in which all subjects were screened for S aureus and selectively treated if positive...
October 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27814559/adhesion-force-of-staphylococcus-aureus-on-various-biomaterial-surfaces
#20
Fahad Alam, Kantesh Balani
Staphylococcus comprises of more than half of all pathogens in orthopedic implant infections and they can cause major bone infection which can result in destruction of joint and bone. In the current study, adhesion force of bacteria on the surface of various biomaterial surfaces is measured using atomic force microscope (AFM). Staphylococcus aureus was immobilized on an AFM tipless cantilever as a force probe to measure the adhesion force between bacteria and biomaterials (viz. ultra-high molecular weight poly ethylene (UHMWPE), stainless steel (SS), Ti-6Al-4V alloy, hydroxyapatite (HA))...
January 2017: Journal of the Mechanical Behavior of Biomedical Materials
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