Terminology of bone and joint infection

Abstract Background Bone and Joint Infections (BJIs) present with non-specific symptoms that may include pain, swelling, and fever and are associated with high morbidity and significant risk of mortality. BJIs can be caused by a variety of bacteria and fungi, including anaerobes and microorganisms that can be challenging to culture or identify by traditional microbiological methods. Clinicians primarily rely on culture to identify the pathogen(s) responsible for infection. The BioFire® Bone and Joint Infection (BJI) Panel (BioFire Diagnostics, Salt Lake City, UT) is designed to detect 15 gram-positive bacteria (including seven anaerobes), 14 gram-negative bacteria (including one anaerobe), two yeast, and eight antimicrobial resistance (AMR) genes from synovial fluid specimens in about an hour. The objective of this study was to evaluate the performance of an Investigational Use Only (IUO) version of the BioFire BJI Panel compared to various reference methods. Methods Remnant synovial fluid specimens, which were collected for routine clinical care at 13 study sites in the US and Europe, underwent testing using an IUO version of the BioFire BJI Panel. Performance of this test was determined by comparison to Standard of Care (SoC) consisting of bacterial culture performed at each study site according to their routine procedures. Results A total of 1544 synovial fluid specimens were collected and tested with the BioFire BJI Panel. The majority of specimens were from knee joints (77.9%) and arthrocentesis (79.4%) was the most common collection method. Compared to SoC culture, overall sensitivity was 90.2% and specificity was 99.8%. The BioFire BJI Panel yielded a total of 268 Detected results, whereas SoC yielded a total of 215 positive results for on-panel analytes. Conclusion The BioFire BJI Panel is a sensitive, specific, and robust test for rapid detection of a wide range of analytes in synovial fluid specimens. The number of microorganisms and resistance genes included in the BioFire BJI Panel, together with a reduced time-to-result and increased diagnostic yield compared to culture, is expected to aid in the timely diagnosis and appropriate management of BJIs. Disclosures Benjamin von Bredow, PhD, BioFire (Grant/Research Support) Jennifer Dien Bard, PhD, BioFire Diagnostic (Consultant, Scientific Research Study Investigator) Bart Kensinger, PhD, BioFire Diagnostics (Employee) Benedicte Pons, PhD, bioMerieux SA (Employee) Corinne Jay, PhD, bioMerieux SA (Employee)

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Bone and joint infection in neonates

The Indian Journal of Pediatrics ◽

10.1007/bf02761144 ◽

1998 ◽

Vol 65 (3) ◽

pp. 461-464 ◽

Cited By ~ 27

Author(s):

Anil Narang ◽

Kanya Mukhopadhyay ◽

Praveen Kumar ◽

O. N. Bhakoo

Keyword(s):

Joint Infection ◽

Bone And Joint Infection

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Prolonged Cefoxitin Infusion Using Mobile Elastomeric Infusors In Outpatients With Bone And Joint Infection

Journal of Bone and Joint Infection ◽

10.7150/jbji.27718 ◽

2018 ◽

Vol 3 (4) ◽

pp. 182-186 ◽

Cited By ~ 3

Author(s):

Zoé Cavalli ◽

Agathe Becker ◽

Alexie Bosch ◽

Anne Conrad ◽

Claire Triffault-Filit ◽

...

Keyword(s):

Continuous Infusion ◽

Intravenous Infusion ◽

Joint Infection ◽

Continuous Intravenous Infusion ◽

Reference Center ◽

Bone And Joint Infection ◽

The Stability ◽

Regional Reference

Abstract. We reviewed all outpatients with bone and joint infection treated with cefoxitin in continuous intravenous infusion using mobile elastomeric infusors in our regional reference center between 2014 and 2017. The stability of cefoxitin provides an interesting and well-tolerated alternative for continuous infusion in outpatients with polymicrobial bone and joint infection.

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Predictive Factors for Successful Treatment in Candidial Bone and Joint Infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.075 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S97-S98

Author(s):

Wooyong Jeong ◽

In Young Jung ◽

Heun Choi ◽

Jinnam Kim ◽

Se Ju Lee ◽

...

Keyword(s):

Predictive Factors ◽

Successful Treatment ◽

Joint Infection ◽

Case Series ◽

Unfavorable Outcome ◽

Neutrophil Lymphocyte Ratio ◽

Bone And Joint Infection ◽

Outcome Group ◽

End Of Treatment ◽

Significant Difference

Abstract Background Candidiasis is a major cause of morbidity and mortality, causing a diverse spectrum of clinical diseases. Candidial bone and joint infection (CBJI) is a rare clinical disease, although it is one associated with significant morbidity. As most prior studies were limited to individual cases and small case series, there were insufficient data on the epidemiology and outcome of CBJI. The aim of this study is to identify the predictive factors for successful treatment in CBJI. Methods A retrospective review was performed on 33 patients with Candida confirmed on culture, among patients diagnosed with bone and joint infection between January 2006 and December 2016 at a 2400-bed tertiary hospital in South Korea. Unfavorable outcome was defined as recurrence following completion of treatment or mortality. Clinical characteristics, treatment outcome, and medical records were reviewed. Results Of the 33 patients, 15 (45.5%) had unfavorable outcomes; recurrence (n = 9) and mortality (n = 6). Median age was 64.0 years (range, 50.5–71.5 years) and there were 14 (42.4%) males. Seventeen (51.5%) patients had arthritis and 16 (48.5%) osteomyelitis. Candida albicans constituted 48.5%, C. parapsilosis 24.2%, C. tropicalis 6.1%, and C. glabrata6.1%. Mechanisms of infection were hematogenous dissemination (57.6%) and direct inoculation (42.4%). There were no significant differences between the favorable outcome group and the unfavorable outcome group for the underlying diseases. The neutrophil percentage in complete blood count at the time of diagnosis showed a difference between the two groups (68.0% vs. 79.6%, P = 0.016). There was a significant difference in neutrophil-lymphocyte ratio (2.2 vs. 4.8, P = 0.023), erythrocyte sedimentation rate (ESR) (40.5 vs. 72.4, P = 0.024) and C-reactive protein (CRP) (15.3 vs. 86.3, P = 0.001) at the end of treatment. The duration of antifungal therapy showed a significant difference (124.9 days vs. 44.3 days, P = 0.041), but there was no difference in the operation. In the multivariate analysis, CRP at the end of treatment  (P = 0.028) ws found to be a predictive factor for successful treatment. Conclusion CBJI is a rare disease but associated with high treatment failure. Prolonged antifungal treatment is essential for successful treatment of CBJI, and CRP at the end of treatment is a key predictive marker of successful treatment. Disclosures All authors: No reported disclosures.

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Bone and Joint Infection in Patients with Sickle Cell Disease

Journal of Pediatric Orthopaedics ◽

10.1097/01241398-198503000-00007 ◽

1985 ◽

Vol 5 (2) ◽

pp. 158-162

Author(s):

Ahmad Mallouh ◽

Younis Talab

Keyword(s):

Sickle Cell Disease ◽

Sickle Cell ◽

Joint Infection ◽

Cell Disease ◽

Bone And Joint Infection

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Local Antimicrobial Treatment in Orthopaedic Surgery

Journal of Bone and Joint Infection ◽

10.7150/jbji.9465 ◽

2017 ◽

Vol 2 (1) ◽

pp. 1-2

Author(s):

Antonia F. Chen ◽

Heinz Winkler

Keyword(s):

Basic Science ◽

Orthopaedic Surgery ◽

Clinical Evidence ◽

Joint Infection ◽

Antimicrobial Treatment ◽

Special Issue ◽

Orthopaedic Surgeons ◽

Bone And Joint Infection

Abstract. The purpose of this special issue of Journal of Bone and Joint Infection is to provide orthopaedic surgeons with basic science explanations as to how these local antimicrobials work, clinical evidence that supports these local treatments, and the role of these local treatments against biofilm.

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