scholarly journals Microbiological Aetiology, Epidemiology, and Clinical Profile of Prosthetic Joint Infections: Are Current Antibiotic Prophylaxis Guidelines Effective?

2012 ◽  
Vol 56 (5) ◽  
pp. 2386-2391 ◽  
Author(s):  
Trisha N. Peel ◽  
Allen C. Cheng ◽  
Kirsty L. Buising ◽  
Peter F. M. Choong
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Content Type ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Surgical Antibiotic Prophylaxis

ABSTRACTProsthetic joint infections remain a major complication of arthroplasty. At present, local and international guidelines recommend cefazolin as a surgical antibiotic prophylaxis at the time of arthroplasty. This retrospective cohort study conducted across 10 hospitals over a 3-year period (January 2006 to December 2008) investigated the epidemiology and microbiological etiology of prosthetic joint infections. There were 163 cases of prosthetic joint infection identified. From a review of the microbiological culture results, methicillin-resistantStaphylococcus aureus(MRSA) and coagulase-negative staphylococci were isolated in 45% of infections. In addition, polymicrobial infections, particularly those involving Gram-negative bacilli and enterococcal species, were common (36%). The majority (88%) of patients received cefazolin as an antibiotic prophylaxis at the time of arthroplasty. In 63% of patients in this cohort, the microorganisms subsequently obtained were not susceptible to the antibiotic prophylaxis administered. The results of this study highlight the importance of ongoing reviews of the local ecology of prosthetic joint infection, demonstrating that the spectrum of pathogens involved is broad. The results should inform empirical antibiotic therapy. This report also provokes discussion about infection control strategies, including changing surgical antibiotic prophylaxis to a combination of glycopeptide and cefazolin, to reduce the incidence of infections due to methicillin-resistant staphylococci.

scholarly journals Periprosthetic Joint Infections: Clinical and Bench Research

2013 ◽  
Vol 2013 ◽  
pp. 1-17 ◽  
Author(s):  
Laurence Legout ◽  
Eric Senneville
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Diagnostic Methods ◽  
High Morbidity ◽  
Substantial Cost ◽  
Prosthetic Infection ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Definition Of

Prosthetic joint infection is a devastating complication with high morbidity and substantial cost. The incidence is low but probably underestimated. Despite a significant basic and clinical research in this field, many questions concerning the definition of prosthetic infection as well the diagnosis and the management of these infections remained unanswered. We review the current literature about the new diagnostic methods, the management and the prevention of prosthetic joint infections.

scholarly journals Prosthetic Joint Infection Due to Histoplasma capsulatum Complicating a Total Knee Arthroplasty

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Cima Nowbakht ◽  
Katherine Garrity ◽  
Nicholas Webber ◽  
Jairo Eraso ◽  
Luis Ostrosky-Zeichner
Keyword(s):  
Total Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Histoplasma Capsulatum ◽  
Joint Infection ◽  
Stage Management ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Oral Itraconazole ◽  
Total Knee

Abstract Histoplasmosis is a common pathogen but rarely reported in prosthetic joint infections. We present a case of Histoplasmosis capsulatum prosthetic joint infection along with a literature review revealing no guidelines or consensus on surgical and antifungal management. We chose the 2-stage management with an antifungal spacer and systemic oral itraconazole.

scholarly journals Micromonas micros Infection of a Prosthetic Hip Joint: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Abhimanyu Aggarwal ◽  
Durane Walker
Keyword(s):  
Antibiotic Prophylaxis ◽  
Hip Joint ◽  
Joint Infection ◽  
Dental Procedure ◽  
Joint Infections ◽  
Prosthetic Joints ◽  
Prosthetic Joint ◽  
Dental Procedures ◽  
Prosthetic Joint Infections ◽  
Hematogenous Seeding

Micromonas micros is an oral anaerobic Gram-positive coccus and is a commensal of the mouth, and it is rarely isolated in prosthetic joint infections (PJIs) and even less frequently related to a preceding dental procedure with eventual hematogenous seeding of the prosthetic joint. Here, we present a case of a 56-year-old male with a prosthetic hip joint who developed Micromonas micros prosthetic hip joint infection with symptoms starting a few days after a dental procedure and not having received periprocedural antibiotic prophylaxis. He recovered well with surgical intervention and antimicrobial therapy. We conducted a literature review of prosthetic hip joint infections caused by Micromonas micros as well as briefly discuss current guidelines on antibiotic prophylaxis in patients with prosthetic joints undergoing dental procedures and some knowledge gaps.

scholarly journals Microbiological Epidemiology Depending on Time to Occurrence of Prosthetic Joint Infection (PJI): Impact on the Empirical Antimicrobial Strategies

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S95-S96
Author(s):  
Tristan Ferry ◽  
Claire Triffault-Fillit ◽  
Frederic Laurent ◽  
Céline Dupieux ◽  
Sébastien Lustig ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Coagulase Negative Staphylococci ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Lactam Antibiotic ◽  
Revision Prosthesis ◽  
Current Guidelines ◽  
Microbiological Data

Abstract Background Empirical antimicrobial therapy of prosthetic-joint infection (PJI) is a major clinical challenge and current guidelines recommend the combination of vancomycin plus a broad-spectrum β-lactamin. As Gram-negative bacilli (GNB) are probably less represented in late infections, we evaluate the microbiological epidemiology in patients with PJI according to the chronology of infection. Methods All patients managed in a reference center for complex bone and joint infections in France (2011 and 2016) were included in a prospective cohort study. Microbiological data at the time of diagnosis were collected and analyzed according to the chronology of infection. Results We included 567 PJI (284 males, 50.1%; median age 70.3 years). The median occurrence time was 23.4 weeks after prosthesis implantation (285 hip and 255 knee PJI, which were revision prosthesis in 216 [40.3%] cases). Microbiological bone samples found 164 [28.9%] S. aureus (including 26 [16.3%] MRSA), 162 [28.6%] coagulase-negative Staphylococci (CoNS, including 80 [58.8%] methicillin-resistant CoNS), 80 (14.1%) Enterobacteriaceae, 74 (13.1%) Streptococci, and 85 (15.0%) anaerobes (including 60 [10.6%] Propionibacterium). Infection was plurimicrobial in 10 [18.2%] cases. Among the 183 patients (32%) with late PJI (occurring >1 year), obtained after exclusion of the 59 patients (10.4%) with hematogenous origins, Enterobacteriacecae 
(n = 8; 4.4%; P < 10–3) were much less represented than in patients with early PJI occurring <1 year. No difference was observed regarding the the presence of non-fermenting GNB, with a prevalence of 4.6 and 2.7% in early and late PJI, respectively. Taken together, these data suggest that a broad-spectrum β-lactam antibiotic might be useful in only 12 (6.6%) patients with late PJI, compared with 66 (20.3%) patients with early PJI (P < 10–3). Of note, there were statistically more anaerobes (n = 40; 21.9%) in late PJI, including 32 Propionibacterium (17.5%; P < 10–3). Conclusion Considering the minority amount of GNB in late post-operative PJI and the overrepresentation of anaerobes including P. acnes, the empirical treatment should be reconsidered, especially when a two-stage exchange is planned. In those situations, another acceptable option could be the vancomycin+clindamycin combination. Disclosures T. Ferry, HERAEUS: Consultant, Speaker honorarium. S. Lustig, Heraeus: Consultant, Consulting fee.

scholarly journals Evaluation of Oritavancin Combinations with Rifampin, Gentamicin, or Linezolid against Prosthetic Joint Infection-Associated Methicillin-ResistantStaphylococcus aureusBiofilms by Time-Kill Assays

2018 ◽  
Vol 62 (10) ◽  
Author(s):  
Qun Yan ◽  
Melissa J. Karau ◽  
Yash S. Raval ◽  
Robin Patel
Keyword(s):  
Staphylococcus Aureus ◽  
Combination Therapy ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Antibiofilm Activity ◽  
Methicillin Resistant ◽  
Content Type ◽  
Prosthetic Joint ◽  
Time Kill

ABSTRACTThe antibiofilm activity of oritavancin in combination with rifampin, gentamicin, or linezolid was evaluated against 10 prosthetic joint infection (PJI)-related methicillin-resistantStaphylococcus aureus(MRSA) isolates by time-kill assays. Oritavancin combined with rifampin demonstrated statistically significant bacterial reductions compared with those of either antimicrobial alone for all 10 isolates (P≤ 0.001), with synergy being observed for 80% of the isolates. Oritavancin and rifampin combination therapy may be an option for treating MRSA PJI.

scholarly journals Same Organism, Different Phenotype - Are Phenotypic Criteria Adequate In Coagulase-Negative Staphylococcal Orthopaedic Implant-Associated Infections?

2019 ◽  
Vol 4 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Staffan Tevell ◽  
Sharmin Baig ◽  
Åsa Nilsdotter-Augustinsson ◽  
Marc Stegger ◽  
Bo Söderquist
Keyword(s):  
Genome Sequencing ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Orthopaedic Implant ◽  
Whole Genome ◽  
Joint Infections ◽  
Staphylococcus Capitis ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Microbiological Criteria

Abstract. In current diagnostic criteria for implant-associated bone- and joint infections, phenotypically identical low-virulence bacteria in two intraoperative cultures are usually required. Using whole-genome sequencing, we have further characterized three phenotypically different Staphylococcus capitis isolated from one prosthetic joint infection, highlighting the challenges in defining microbiological criteria for low-virulence prosthetic joint infections.

scholarly journals Treatment of <i>Neisseria meningitidis</i> prosthetic joint infections with short-course antibiotics: three cases and a literature review

2020 ◽  
Vol 6 (2) ◽  
pp. 33-37
Author(s):  
Sarah Browning ◽  
Harry N. Walker ◽  
Thomas Ryan ◽  
Robert Pickles ◽  
Michael Loftus ◽  
...  
Keyword(s):  
Literature Review ◽  
Neisseria Meningitidis ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Short Course ◽  
Prosthetic Joint Infections ◽  
Implant Retention

Abstract. Neisseria meningitidis is a rare cause of prosthetic joint infection (PJI), with only three cases previously reported. Here we report three further cases, all of which were successfully treated with implant retention and short-course antibiotics (<6 weeks).

scholarly journals Minocycline Combined with Vancomycin for the Treatment of Methicillin-Resistant Coagulase-Negative Staphylococcal Prosthetic Joint Infection Managed with Exchange Arthroplasty

2020 ◽  
Vol 5 (3) ◽  
pp. 110-117
Author(s):  
Géraldine Bart ◽  
Valérie Zeller ◽  
Younes Kerroumi ◽  
Beate Heym ◽  
Vanina Meyssonnier ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Joint Infection ◽  
Survival Rates ◽  
Methicillin Resistant ◽  
One Stage ◽  
Joint Infections ◽  
Exchange Arthroplasty ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Abstract. Introduction: Treatment of methicillin-resistant (MR) staphylococcal prosthetic joint infections (PJIs) remains a matter of discussion, with vancomycin-rifampin combination therapy being the preferred treatment for DAIR and one-stage exchange arthroplasty strategies. This study analyzes the outcomes of patients with chronic methicillin-resistant coagulase-negative staphylococcal PJIs treated with vancomycin-minocycline combination therapy.Methods: This prospective, single center cohort study included all chronic MR coagulase-negative staphylococcal PJIs (01/2004-12/2014) treated with exchange arthroplasty and at least 4 weeks of minocycline-vancomycin. The following endpoints were considered: reinfection including relapse (same microorganism) and a new infection (different microorganism) and PJI-related deaths. Their outcomes were compared with PJIs treated with rifampin-vancomycin during the same period.Results: Thirty-four patients (median age, 69 years) with 22 hip and 12 knee arthroplasty infections were included. Sixteen (47%) had previously been managed in another center. Median vancomycin MIC of strains was 3 mg/L. Nineteen underwent one-stage, 15 two-stage exchange arthroplasty. After a median [IQR] follow-up of 43 [26-68] months, 2 patients relapsed and 6 developed a new PJI. Compared to 36 rifampin-vancomycin treated PJIs, relapse- or reinfection-free survival rates didn't differ, but more new infections developed in the minocycline group (6 vs 3; P 0.3).Conclusions: Minocycline-vancomycin combination therapy for chronic MR coagulase-negative staphylococcal PJIs seems to be an interesting therapeutic alternative.

scholarly journals Intraoperative Bacterial Contamination and Activity of Different Antimicrobial Prophylaxis Regimens in Primary Knee and Hip Replacement

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 18
Author(s):  
Alba Rivera ◽  
Alba Sánchez ◽  
Sonia Luque ◽  
Isabel Mur ◽  
Lluís Puig ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Bacterial Contamination ◽  
Antimicrobial Prophylaxis ◽  
Coagulase Negative Staphylococci ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Total Knee ◽  
Surgical Antimicrobial Prophylaxis ◽  
Almost All

Surgical antimicrobial prophylaxis (SAP) is important for the prevention of prosthetic joint infections (PJIs) and must be effective against the microorganisms most likely to contaminate the surgical site. Our aim was to compare different SAP regimens (cefazolin, cefuroxime, or vancomycin, alone or combined with gentamicin) in patients undergoing total knee (TKA) and hip (THA) arthroplasty. In this preclinical exploratory analysis, we analyzed the results of intraoperative sample cultures, the ratio of plasma antibiotic levels to the minimum inhibitory concentrations (MICs) for bacteria isolated at the surgical wound and ATCC strains, and serum bactericidal titers (SBT) against the same microorganisms. A total of 132 surgical procedures (68 TKA, 64 THA) in 128 patients were included. Cultures were positive in 57 (43.2%) procedures (mostly for coagulase-negative staphylococci and Cutibacterium spp.); the rate was lower in the group of patients receiving combination SAP (adjusted OR 0.475, CI95% 0.229–0.987). The SAP regimens evaluated achieved plasma levels above the MICs in almost all of intraoperative isolates (93/94, 98.9%) and showed bactericidal activity against all of them (SBT range 1:8–1:1024), although SBTs were higher in patients receiving cefazolin and gentamicin-containing regimens. The potential clinical relevance of these findings in the prevention of PJIs remains to be determined.

scholarly journals Comparative genomics of Staphylococcus epidermidis from prosthetic-joint infections and nares highlights genetic traits associated with antimicrobial resistance, not virulence

2021 ◽  
Author(s):  
Emeli Månsson ◽  
Thor Bech Johannesen ◽  
Åsa Nilsdotter-Augustinsson ◽  
Bo Söderquist ◽  
Marc Stegger
Keyword(s):  
Population Structure ◽  
Antimicrobial Resistance ◽  
Staphylococcus Epidermidis ◽  
Type Species ◽  
Genetic Traits ◽  
Content Type ◽  
Link Type ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

There is increased awareness of the worldwide spread of specific epidemic multidrug-resistant (MDR) lineages of the human commensal Staphylococcus epidermidis . Here, using bioinformatic analyses accounting for population structure, we determined genomic traits (genes, SNPs and k-mers) that distinguish S. epidermidis causing prosthetic-joint infections (PJIs) from commensal isolates from nares, by analysing whole-genome sequencing data from S. epidermidis from PJIs prospectively collected over 10 years in Sweden, and contemporary S. epidermidis from the nares of patients scheduled for arthroplasty surgery. Previously suggested virulence determinants and the presence of genes and mutations linked to antimicrobial resistance (AMR) were also investigated. Publicly available S. epidermidis sequences were used for international extrapolation and validation of findings. Our data show that S. epidermidis causing PJIs differed from nasal isolates not by virulence but by traits associated with resistance to compounds used in prevention of PJIs: β-lactams, aminoglycosides and chlorhexidine. Almost a quarter of the PJI isolates did not belong to any of the previously described major nosocomial lineages, but the AMR-related traits were also over-represented in these isolates, as well as in international S. epidermidis isolates originating from PJIs. Genes previously associated with virulence in S. epidermidis were over-represented in individual lineages, but failed to reach statistical significance when adjusted for population structure. Our findings suggest that the current strategies for prevention of PJIs select for nosocomial MDR S. epidermidis lineages that have arisen from horizontal gene transfer of AMR-related traits into multiple genetic backgrounds.

Sign in / Sign up

Export Citation Format

Share Document