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Arthroplasty infection by staphylococcus

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https://www.readbyqxmd.com/read/28691647/microbiological-diagnosis-in-revision-of-infected-knee-arthroplasties-in-denmark
#1
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
#2
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
#3
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
#4
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/28507783/periprosthetic-shoulder-infection-an-overview
#5
REVIEW
Nicolas Bonnevialle, Florence Dauzères, Julien Toulemonde, Fanny Elia, Jean-Michel Laffosse, Pierre Mansat
Periprosthetic shoulder infection (PSI) is rare but potentially devastating. The rate of PSI is increased in cases of revision procedures, reverse shoulder implants and co-morbidities. One specific type of PSI is the occurrence of low-grade infections caused by non-suppurative bacteria such as Propionibacterium acnes or Staphylococcus epidemermidis.Success of treatment depends on micro-organism identification, appropriate surgical procedures and antibiotic administration efficiency. Post-operative early PSI can be treated with simple debridement, while chronic PSI requires a one- or two-stage revision procedure...
April 2017: EFORT Open Rev
https://www.readbyqxmd.com/read/28461965/total-knee-arthroplasty-and-infection-how-surgeons-can-reduce-the-risks
#6
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/28420544/disclosing-agents-for-the-intraoperative-identification-of-biofilms-on-orthopedic-implants
#7
Joshua A Parry, Melissa J Karau, Sanjeev Kakar, Arlen D Hanssen, Robin Patel, Matthew P Abdel
BACKGROUND: Disclosing agents are dyes used in dentistry to colorize plaque (biofilm) and may offer a means for intraoperative detection of biofilms on orthopedic implants. Methylene blue (MB) stains biofilm and is safely used in orthopedic applications. Injection of MB into acutely infected prosthetic knees before debridement may enable visualization of biofilm, which could influence treatment decisions. The aims of this study were to determine if MB could be used to visualize biofilm on total knee arthroplasty (TKA) implants and to determine if MB staining has an antimicrobial effect that might interfere with subsequent culture...
March 16, 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
#8
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
https://www.readbyqxmd.com/read/28361019/results-of-single-stage-exchange-arthroplasty-with-retention-of-well-fixed-cement-less-femoral-component-in-management-of-infected-total-hip-arthroplasty
#9
Wael A Rahman, Hussain A Kazi, Jeffery D Gollish
AIM: To investigate success of one stage exchange with retention of fixed acetabular cup. METHODS: Fifteen patients treated by single stage acetabular component exchange with retention of well-fixed femoral component in infected total hip arthroplasty (THA) were retrospectively reviewed. Inclusion criteria were patients with painful chronic infected total hip. The patient had radiologically well fixed femoral components, absence of major soft tissue or bone defect compromising, and infecting organism was not poly or virulent micro-organism...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#10
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...
July 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28260022/thin-magnesium-layer-confirmed-as-an-antibacterial-and-biocompatible-implant-coating-in-a-co%C3%A2-culture-model
#11
Sarah Zaatreh, David Haffner, Madlen Strauss, Thomas Dauben, Christiane Zamponi, Wolfram Mittelmeier, Eckhard Quandt, Bernd Kreikemeyer, Rainer Bader
Implant-associated infections commonly result from biofilm‑forming bacteria and present severe complications in total joint arthroplasty. Therefore, there is a requirement for the development of biocompatible implant surfaces that prevent bacterial biofilm formation. The present study coated titanium samples with a thin, rapidly corroding layer of magnesium, which were subsequently investigated with respect to their antibacterial and cytotoxic surface properties using a Staphylococcus epidermidis (S. epidermidis) and human osteoblast (hOB) co‑culture model...
April 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28162880/surgical-management-of-periprosthetic-shoulder-infections
#12
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/28116254/bilateral-prosthetic-hip-joint-infections-associated-with-a-psoas-abscess-a-case-report
#13
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/27980378/operating-room-environment-and-surgical-site-infections-in-arthroplasty-procedures
#14
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
#15
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
#16
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/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/27823845/decreased-hospital-costs-and-surgical-site-infection-incidence-with-a-universal-decolonization-protocol-in-primary-total-joint-arthroplasty
#18
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/27749085/polymerase-chain-reaction-electrospray-time-of-flight-mass-spectrometry-versus-culture-for-bacterial-detection-in-septic-arthritis-and-osteoarthritis
#19
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...
December 2016: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/27744001/epidemiology-of-patients-with-mssa-versus-mrsa-infections-of-orthopedic-implants-retrospective-study-of-115-patients
#20
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
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