scholarly journals Risk of Recurrent Staphylococcus aureus Prosthetic Joint Infection in Rheumatoid Arthritis Patients—A Nationwide Cohort Study

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Namrata Singh ◽  
Rajeshwari Nair ◽  
Michihiko Goto ◽  
Martha L Carvour ◽  
Ryan Carnahan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Prosthetic Joint Infection ◽  
Proportional Hazards ◽  
Joint Infection ◽  
International Classification Of Diseases ◽  
Cox Proportional Hazards ◽  
Prosthetic Joint ◽  
Implant Retention

AbstractBackgroundTreatment of rheumatoid arthritis (RA) often involves immune-suppressive therapies. Concern for recurrent prosthetic joint infection (PJI) in RA patients might be high and could reduce use of joint implantation in these patients. We aimed to evaluate the risk of recurrence of PJI in RA patients compared with osteoarthritis (OA) patients by utilizing a large health care system.MethodsWe conducted a retrospective cohort study of all patients admitted for a Staphylococcus aureus PJI who underwent debridement, antibiotics, and implant retention (DAIR) or 2-stage exchange (2SE) between 2003 and 2010 at 86 Veterans Affairs Medical Centers. Both RA patients and the comparison group of osteoarthritis (OA) patients were identified using International Classification of Diseases, Ninth Revision, codes. All index PJI and recurrent positive cultures for S. aureus during 2 years of follow-up were validated by manual chart review. A Cox proportional hazards regression model was used to compare the time to recurrent PJI for RA vs OA.ResultsIn our final cohort of 374 veterans who had either DAIR or 2SE surgery for their index S. aureus PJI, 11.2% had RA (n = 42). The majority of the cohort was male (97.3%), and 223 (59.6%) had a methicillin-susceptible S. aureus PJI. RA patients had a similar risk of failure compared with OA patients, after adjusting for covariates (hazard ratio, 0.81; 95% confidence interval, 0.48–1.37).ConclusionsPrior diagnosis of RA does not increase the risk of recurrent S. aureus PJI. Further studies are needed to evaluate the effect of different RA therapies on outcomes of episodes of PJI.

Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis: a nationwide cohort study using Danish healthcare registers

2017 ◽  
Vol 77 (2) ◽  
pp. 281-288 ◽  
Author(s):  
Rene Lindholm Cordtz ◽  
Kristian Zobbe ◽  
Pil Højgaard ◽  
Lars Erik Kristensen ◽  
Søren Overgaard ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Risk Of Death ◽  
Prosthetic Joint ◽  
Increased Risk ◽  
Total Knee

ObjectivesTo investigate predictors of 10-year risk of revision and 1-year risk of prosthetic joint infection (PJI) and death following total hip/total knee arthroplasty (THA/TKA) in (1) patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA); and (2) patients with RA treated with biological disease-modifying antirheumatic drugs (bDMARD) within 90 days preceding surgery compared with non-treated.MethodsRegister-based cohort study using the Danish National Patient Register, the DANBIO rheumatology register (RA-specific confounders and treatment episodes) and the Danish Hip and Knee Arthroplasty Registers. Survival analyses were used to calculate confounder-adjusted sub-HRs (SHR) and HRs.ResultsIn total, 3913 patients with RA with THA/TKA were compared with 120 499 patients with OA. Patients with RA had decreased risk of revision (SHR 0.71 (0.57–0.89)), but increased risk of PJI (SHR=1.46 (1.13–1.88)) and death (HR=1.25 (1.01–1.55)). In DANBIO, 345 of 1946 patients with RA with THA/TKA had received bDMARD treatment within 90 days preceding surgery. bDMARD-treated patients did not have a statistically significant increased risk of revision (SHR=1.49 (0.65–3.40)), PJI (SHR=1.61 (0.70–3.69)) nor death (HR=0.75 (0.24–2.33)) compared with non-treated. Glucocorticoid exposure (HR=2.87 (1.12–7.34)) and increasing DAS28 (HR=1.49 (1.01–2.20)) were risk factors for mortality.ConclusionPatients with RA had a decreased 10-year risk of revision while the risk of death and PJI was increased compared with patients with OA following THA/TKA. bDMARD exposure was not associated with statistically significant increased risk of neither PJI nor death in this study. Glucocorticoid exposure and increased disease activity were associated with an increased risk of death.

scholarly journals Salvage Debridement, Antibiotics and Implant Retention (“DAIR”) With Local Injection of a Selected Cocktail of Bacteriophages: Is It an Option for an Elderly Patient With Relapsing Staphylococcus aureus Prosthetic-Joint Infection?

2018 ◽  
Vol 5 (11) ◽  
Author(s):  
Tristan Ferry ◽  
Gilles Leboucher ◽  
Cindy Fevre ◽  
Yannick Herry ◽  
Anne Conrad ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Prosthetic Joint Infection ◽  
Clinical Success ◽  
Joint Infection ◽  
Salvage Treatment ◽  
Local Injection ◽  
Scientific Evaluation ◽  
Potential Clinical Benefit ◽  
Prosthetic Joint ◽  
Implant Retention

Abstract Local injection of a bacteriophages mix during debridement, antibiotics and implant retention (“DAIR”) was performed to treat a relapsing Staphylococcus aureus chronic prosthetic joint infection (PJI). This salvage treatment was safe and associated with a clinical success. Scientific evaluation of the potential clinical benefit of bacteriophages as antibiofilm treatment in PJI is now feasible and required.

scholarly journals Successful Treatment of Staphylococcus aureus Prosthetic Joint Infection with Bacteriophage Therapy

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1182
Author(s):  
Claudia Ramirez-Sanchez ◽  
Francis Gonzales ◽  
Maureen Buckley ◽  
Biswajit Biswas ◽  
Matthew Henry ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Multidrug Resistant ◽  
Successful Outcome ◽  
Prolonged Treatment ◽  
Lytic Phage ◽  
Bacteriophage Therapy ◽  
Prosthetic Joint ◽  
Knee Joint Infection

Successful joint replacement is a life-enhancing procedure with significant growth in the past decade. Prosthetic joint infection occurs rarely; it is a biofilm-based infection that is poorly responsive to antibiotic alone. Recent interest in bacteriophage therapy has made it possible to treat some biofilm-based infections, as well as those caused by multidrug-resistant pathogens, successfully when conventional antibiotic therapy has failed. Here, we describe the case of a 61-year-old woman who was successfully treated after a second cycle of bacteriophage therapy administered at the time of a two-stage exchange procedure for a persistent methicillin-sensitive Staphylococcus aureus (MSSA) prosthetic knee-joint infection. We highlight the safety and efficacy of both intravenous and intra-articular infusions of bacteriophage therapy, a successful outcome with a single lytic phage, and the development of serum neutralization with prolonged treatment.

Ceftriaxone susceptibility of oxacillin-susceptible Staphylococcus aureus from patients with prosthetic joint infection

2015 ◽  
Vol 82 (2) ◽  
pp. 177-178 ◽  
Author(s):  
Kerryl E. Greenwood-Quaintance ◽  
Peggy Kohner ◽  
Douglas R. Osmon ◽  
Abinash Virk ◽  
Robin Patel
Keyword(s):  
Staphylococcus Aureus ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Joint

Assessing risk of prosthetic joint infection

2018 ◽  
pp. 9-12
Author(s):  
Umraz Khan ◽  
Graeme Perks ◽  
Rhidian Morgan-Jones ◽  
Peter James ◽  
Colin Esler ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
High Risk ◽  
Prosthetic Joint Infection ◽  
Elective Surgery ◽  
Joint Infection ◽  
High Risk Patient ◽  
Prosthetic Joint ◽  
Risk Patients ◽  
Marginal Gain ◽  
Cellular Turnover

This chapter discusses assessing the risk of prosthetic joint infection (PJI) and includes discussion on high-risk patients (classified by age, skin colour, extracellular matrix, cellular turnover, diabetes, obesity, rheumatoid arthritis, previous periarticular fractures and skin disorders). The aim is to allow the practitioner to identify high-risk patient attributes that can be positively influenced such that the risk of PJI is reduced. There are some patients with more than one risk factor and, as such, every effort must be made to reduce each even if there is a marginal gain in each. Delaying elective surgery until the risks of PJI are reduced must be encouraged but must be balanced with alleviating patient symptoms.

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