scholarly journals Efficacy of mupirocin, neomycin and octenidine for nasal Staphylococcus aureus decolonisation: a retrospective cohort study

2022 ◽  
Vol 11 (1) ◽  
Author(s):  
J. Allport ◽  
R. Choudhury ◽  
P. Bruce-Wootton ◽  
M. Reed ◽  
D. Tate ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Periprosthetic Joint Infection ◽  
Retrospective Cohort ◽  
Joint Infection ◽  
Poor Correlation ◽  
Preoperative Screening ◽  
Significant Morbidity ◽  
Knee Replacements ◽  
Nasal Mupirocin

Abstract Background Periprosthetic joint infection (PJI) causes significant morbidity. Methicillin sensitive Staphylococcus aureus (MSSA) is the most frequent organism, and the majority are endogenous. Decolonisation reduces PJIs but there is a paucity of evidence comparing treatments. Aims; compare 3 nasal decolonisation treatments at (1) achieving MSSA decolonisation, (2) preventing PJI. Methods Our hospital prospectively collected data on our MSSA decolonisation programme since 2013, including; all MSSA carriers, treatment received, MSSA status at time of surgery and all PJIs. Prior to 2017 MSSA carriers received nasal mupirocin or neomycin, from August 2017 until August 2019 nasal octenidine was used. Results During the study period 15,958 primary hip and knee replacements were performed. 3200 (20.1%) were MSSA positive at preoperative screening and received decolonisation treatment, 698 mupirocin, 1210 neomycin and 1221 octenidine. Mupirocin (89.1%) and neomycin (90.9%) were more effective at decolonisation than octenidine (50.0%, P < 0.0001). There was no difference in PJI rates (P = 0.452). Conclusions Mupirocin and neomycin are more effective than octenidine at MSSA decolonisation. There was poor correlation between the MSSA status after treatment (on day of surgery) and PJI rates. Further research is needed to compare alternative MSSA decolonisation treatments.

scholarly journals The change of coagulation profile in two-staged arthroplasty for periprosthetic joint infection patients: a retrospective cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hao Li ◽  
Rui Li ◽  
L. L. Li ◽  
Wei Chai ◽  
Chi Xu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Periprosthetic Joint Infection ◽  
Retrospective Cohort Study ◽  
Persistent Infection ◽  
Retrospective Cohort ◽  
Joint Infection ◽  
Diagnostic Study ◽  
Level Of Evidence ◽  
Coagulation Profile ◽  
Significant Difference

Abstract Aims Periprosthetic joint infection (PJI) is a serious complication of total joint arthroplasty. We performed a retrospective cohort study to evaluate (1) the change of coagulation profile in two-staged arthroplasty patients and (2) the relationship between coagulation profile and the outcomes of reimplantation. Method Between January 2011 and December 2018, a total of 202 PJI patients who were operated on with two-staged arthroplasty were included in this study initially. This study continued for 2 years and the corresponding medical records were scrutinized to establish the diagnosis of PJI based on the 2014 MSIS criteria. The coagulation profile was recorded at two designed points, (1) preresection and (2) preimplantation. The difference of coagulation profile between preresection and preimplantation was evaluated. Receiver operating characteristic curves (ROC) were used to evaluate the diagnostic efficiency of the coagulation profile and change of coagulation profile for predicting persistent infection before reimplantation. Results The levels of APTT, INR, platelet count, PT, TT, and plasma fibrinogen before spacer implantation were significantly higher than before reimplantation. No significant difference was detected in the levels of D-dimer, ACT, and AT3 between the two groups. The AUC of the combined coagulation profile and the change of combined coagulation profile for predicting persistent infection before reimplantation was 0.667 (95% CI 0.511, 0.823) and 0.667 (95% CI 0.526, 0.808), respectively. Conclusion The coagulation profile before preresection is different from before preimplantation in two-staged arthroplasty and the coagulation markers may play a role in predicting infection eradication before reimplantation when two-stage arthroplasty is performed. Level of evidence Level III, diagnostic study.

The Change of Coagulation Profile in Two-staged Arthroplasty for Periprosthetic Joint Infection Patients：A Retrospective Cohort Study

2021 ◽  
Author(s):  
Hao Li ◽  
Rui Li ◽  
Liangliang Li ◽  
Chi Xu ◽  
Wei Chai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Periprosthetic Joint Infection ◽  
Retrospective Cohort Study ◽  
Persistent Infection ◽  
Retrospective Cohort ◽  
Joint Infection ◽  
Diagnostic Study ◽  
Level Of Evidence ◽  
Coagulation Profile ◽  
Significant Difference

Abstract Aims：Periprosthetic joint infection (PJI) a serious complication of total joint arthroplasty. We performed a retrospective cohort study to evaluate 1) the change of coagulation profile in two-staged arthroplasty patients 2) the relationship between coagulation profile and the outcomes of reimplantation. Method: Between 2011 January and 2018 December, a total of 202 PJI patients who were performed with two-staged arthroplasty were included in this study initially. They were followed up at least 2 years and corresponding medical records were scrutinized to establish the diagnosis of PJI based on the 2014 MSIS criteria. The coagulation profile was recorded at two designed points 1) preresection and 2) preimplantation. Then, the difference of coagulation profile between preresection and preimplantation was evaluated. Besides, receiver operating characteristic curves (ROC) were used to evaluate the diagnostic efficiency of coagulation profile and the change of coagulation profile for predicting persistent infection before reimplantation. Results: The levels of APTT, INR, platelet count, PT, TT and plasma fibrinogen before spacer implantation were significantly higher than that before reimplantation. No significant difference was detected in the levels of D-dimer, ACT, AT3 between the two groups. The AUC of the combined coagulation profile and the change of combined coagulation profile for predicting persistent infection before reimplantation was 0.667 (95%CI:(0.511,0.823) and 0.667 (95%CI: (0.526,0.808)), respectively.Conclusion: The coagulation profile before preresection is different from that before preimplantation in two-staged arthroplasty and the coagulation markers may play a role in predicting infection eradication before reimplantation when two-stage arthroplasty is performed. Level of Evidence: level III, diagnostic study

scholarly journals Subclinical Abnormal Coagulation in Periprosthetic Joint Infection: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Hao Li ◽  
Jun Fu ◽  
Wei Chai ◽  
Chi Xu ◽  
Libo Hao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Platelet Count ◽  
Periprosthetic Joint Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Joint Infection ◽  
Plasma Fibrinogen ◽  
Diagnostic Efficacy ◽  
Coagulation Profile ◽  
D Dimer

Abstract Background：Periprosthetic joint infection (PJI) is a serious complication of total joint arthroplasty and often indicate disastrous outcomes. However, the change of coagulation profile in PJI patients has not been explored up to now. Therefore, we performed a single-center retrospective cohort study to determine: 1) the coagulation profile in PJI patients 2) the diagnostic efficacy of coagulation profile for PJI diagnosis based on the MSIS criteria.Methods: Between 2016 January and 2018 December, a total of 371 patients receiving joint revisions were included in this cohort study. The corresponding medical records were scrutinized to establish the final diagnosis of PJI according to the 2014 MSIS criteria. The difference of coagulation profile between PJI and aseptic loosening patients was analyzed. Moreover, receiver operating characteristic curves were used to determine the proper sensitivity and specificity of coagulation makers.Results: The levels of APTT, D-dimer, plasma fibrinogen, INR and Platelet Count in PJI group were significantly higher than that in non-PJI group(P<0.05). The AUCs of plasma APTT, plasma D-dimer, plasma fibrinogen and platelet count for PJI diagnosis were0.625(95%CI:(0.543,0.706)),0.731(95%CI:(0.656,0.806)),0.831(95%CI:(0.771,0.890)) and 0.733(95%CI:(0.660,0.805)), respectively. Moreover, the coagulation profile was combined by logistic model and the corresponding AUC was0.865(95%CI:(0.812,0.918)).Conclusions: Despite relatively normal coagulation profile, PJI patients suffer from subclinical abnormal coagulation compared to non-PJI patients. The coagulation profile (APTT, INR, plasma fibrinogen, platelet count, D-dimer) in PJI patients is different from that in non-PJI patients significantly. And the coagulation profile can play a role in PJI diagnosis.

scholarly journals Staphylococcus aureus bloodstream infection in patients with prosthetic joint included in the prospective VIRSTA cohort study: frequency and time of occurrence of periprosthetic joint infection

2019 ◽  
Author(s):  
Sébastien Dufour ◽  
Lionel Piroth ◽  
Catherine Chirouze ◽  
Pierre Tattevin ◽  
Agathe Becker ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Bloodstream Infection ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Staphylococcus Aureus Bacteremia ◽  
Prosthetic Joint ◽  
Staphylococcus Aureus Bloodstream Infection

Abstract Among 143 patients of the VIRSTA cohort study having Staphylococcus aureus bacteremia and an arthroplasty implanted for more than a year, S. aureus periprosthetic joint infection was observed in 19%. Signs of infection (pain and swelling) were always present, in median 1 day (extremes: 0- 21) after onset of bacteremia.

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