scholarly journals Prosthetic Joint Infections: Bane of Orthopedists, Challenge for Infectious Disease Specialists

2003 ◽  
Vol 36 (9) ◽  
pp. 1157-1161 ◽  
Author(s):  
Joseph R. Lentino
Keyword(s):  
Infectious Disease ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Infectious Disease Specialists

scholarly journals Metagenomics for Clinical Infectious Disease Diagnostics Steps Closer to Reality

2018 ◽  
Vol 56 (9) ◽  
Author(s):  
John P. Dekker
Keyword(s):  
Infectious Disease ◽  
Clinical Microbiology ◽  
Clinical Infectious Disease ◽  
Clinical Microbiology Laboratory ◽  
Shotgun Metagenomics ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Disease Diagnostics ◽  
Infectious Disease Diagnostics ◽  
Prosthetic Joint Infections

ABSTRACT Metagenomics approaches based on shotgun next-generation sequencing hold promise for infectious disease diagnostics. Despite substantial challenges that remain, work done over the past few years justifies excitement about the potential for these approaches to transform how clinical pathogen identification and analysis are performed. In an article in this issue of the Journal of Clinical Microbiology, M. I. Ivy et al. (J Clin Microbiol 56:e00402-18, 2018, https://doi.org/10.1128/JCM.00402-18) have applied a shotgun metagenomics approach to the diagnosis of prosthetic joint infections directly from synovial fluid. The results from this work demonstrate both the potentials and challenges of this approach applied in the clinical microbiology laboratory.

Reflecting on and managing the emotional impact of prosthetic joint infections on orthopaedic surgeons—a qualitative study

2020 ◽  
Vol 102-B (6) ◽  
pp. 736-743 ◽  
Author(s):  
Karin Svensson ◽  
Ola Rolfson ◽  
Maziar Mohaddes ◽  
Henrik Malchau ◽  
Annette Erichsen Andersson
Keyword(s):  
Peer Support ◽  
Joint Infection ◽  
Sampling Strategy ◽  
Emotional Impact ◽  
Multidisciplinary Teams ◽  
Orthopaedic Surgeons ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Infectious Disease Specialists

Aims To investigate the experience and emotional impact of prosthetic joint infection (PJI) on orthopaedic surgeons and identify holistic strategies to improve the management of PJI and protect surgeons’ wellbeing. Methods In total, 18 prosthetic joint surgeons in Sweden were recruited using a purposive sampling strategy. Content analysis was performed on transcripts of individual in-person interviews conducted between December 2017 and February 2018. Results PJI had a negative emotional impact on Swedish surgeons. Many felt guilt, stress, and a sense of failure, and several aspects of PJI management were associated with psychosocial challenges. Peer support was reported as the most important coping strategy as was collaborating with infectious disease specialists. Conclusion Our study affirms that there is a negative emotional impact of PJI on surgeons which can be minimized by improved peer support and working in multidisciplinary teams. Based on the surgeons’ experiences we have identified desired improvements that may facilitate the management of PJI. These may also be applicable within other surgical specialties dealing with postoperative infections, but need to be evaluated for their efficacy. Cite this article: Bone Joint J 2020;102-B(6):736–743.

scholarly journals Using Nuclear Medicine Imaging Wisely in Diagnosing Infectious Diseases

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Andrea Censullo ◽  
Tara Vijayan
Keyword(s):  
Infectious Disease ◽  
Nuclear Medicine ◽  
Diagnostic Testing ◽  
Vertebral Osteomyelitis ◽  
Nuclear Imaging ◽  
Nuclear Medicine Imaging ◽  
Joint Infections ◽  
Diabetic Foot Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

AbstractIn recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine’s “Choosing Wisely” campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad.This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources. Fluorodeoxyglucose-positron emission tomography (FDG-PET) with computed tomography (CT) and sulfur colloid imaging with tagged white blood cell (WBC) scanning offer the most promise in facilitating rapid and accurate diagnoses of endovascular graft infections, vertebral osteomyelitis (V-OM), diabetic foot infections, and prosthetic joint infections (PJIs). However, radiologists at different institutions may have varying degrees of expertise with these modalities.Regardless, infectious disease consultants would benefit from knowing what nuclear medicine tests to order when considering patients with complex infectious disease syndromes.

scholarly journals Management of prosthetic joint infections in France: a national audit to identify key situations requiring innovation and homogenization

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marion Le Maréchal ◽  
Zoé Cavalli ◽  
Cécile Batailler ◽  
Jean-François Gonzalez ◽  
André Ferreira ◽  
...  
Keyword(s):  
Infectious Disease ◽  
National Audit ◽  
Antibiotic Regimen ◽  
Multidisciplinary Team Meeting ◽  
One Stage ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Disease Specialist ◽  
Clinical Cases

Abstract Background Prosthetic joint infections (PJI) are one of the most serious complication of arthroplasty. The management of PJI needs a multidisciplinary collaboration between orthopaedic surgeon, infectious disease specialist and microbiologist. In France, the management of PJI is organized around reference centres (CRIOACs). Our main objective was to perform an audit through a questionnaire survey based on clinical cases, to evaluate how French physicians manage PJI. Eligible participants were all physicians involved in care of patients presenting a PJI. Physicians could answer individually, or collectively during a multidisciplinary team meeting dedicated to PJI. The survey consisted as three questionnaires organized in a total of six clinical cases. Results Answers from the CRIOACs to the three questionnaires were 92, 77, and 53%. Between 32 and 39% of respondents did not administer antibiotic prophylaxis despite positive S. aureus pre-operative documentation. One-stage exchange strategy was widely preferred in all clinical cases, with no difference between CRIOACs and other centres. Rifampicin was prescribed for S. aureus PJI, in a situation with (90–92%) or without any prosthesis (70%). There was no consensus for the total antibiotic regimen duration, with prescriptions from six to 12 weeks for a majority of respondents. Conclusions Surgical strategy for the management of PJI was homogenous with a preference for a one-stage exchange strategy. Medical management was more heterogenous, which reflects the heterogeneity of those infections and difficulties to perform studies with strong conclusions.

scholarly journals Genomic Analysis of Cutibacterium acnes Strains Isolated from Prosthetic Joint Infections

2021 ◽  
Vol 9 (7) ◽  
pp. 1500
Author(s):  
Llanos Salar-Vidal ◽  
Yvonne Achermann ◽  
John-Jairo Aguilera-Correa ◽  
Anja Poehlein ◽  
Jaime Esteban ◽  
...  
Keyword(s):  
Normal Skin ◽  
Genomic Analysis ◽  
Healthy Skin ◽  
Common Cause ◽  
Good Outcome ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Cutibacterium Acnes ◽  
Clinical Conditions

Cutibacterium acnes is a common cause of prosthetic joint infections (PJIs). The C. acnes population can be divided into six main phylotypes (IA1, IA2, IB, IC, II and III) that are associated with different clinical conditions and normal skin. A single-locus sequence typing (SLST) scheme can distinguish ten main SLST types: A-E (all IA1), F (IA2), G (IC), H (IB), K (II), L (III). We genome-sequenced and compared 16 strains of C. acnes isolated from healthy skin (n = 4) and PJIs (n = 12), including six PJI cases with a good outcome (four shoulder PJIs, one hip PJI, one knee PJI) and six with infection relapse (three shoulder PJIs, three hip PJIs). The sequenced strains belonged to four different phylotypes (IA1, IA2, IB and II) and seven different SLST types. All five type IB strains (all SLST type H1) were PJI isolates (three hip PJIs, two shoulder PJIs), and four of these caused infection relapse (three hip PJIs, one shoulder PJI). Isolates from PJI cases with a good outcome belonged to three different phylotypes (IA, IB, II). Interestingly, four strains (three strains from PJI cases with good outcome and one strain from healthy skin) contained a linear plasmid; these strains belonged to different SLST types (A1, C1, F4, H1) and were isolated in three different hospitals. This study suggests that type IB strains have the potential to cause infection relapse, in particular regarding hip PJIs. Moreover, our study revealed that strains belonging to the same SLST type can differ in their accessory genome in different geographic locations, indicative of microevolution.

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