scholarly journals Viewpoint: Periprosthetic joint infection and dental antibiotic prophylaxis guidelines

2021 ◽  
Vol 6 (8) ◽  
pp. 363-366
Author(s):  
Miao Xian Zhou ◽  
Elie F. Berbari ◽  
Cory G. Couch ◽  
Scott F. Gruwell ◽  
Alan B. Carr
Keyword(s):  
Infectious Disease ◽  
Antibiotic Prophylaxis ◽  
Periprosthetic Joint Infection ◽  
Mayo Clinic ◽  
Joint Infection ◽  
Orthopedic Surgeons ◽  
Dental Procedures

Abstract. The purpose of this viewpoint is to provide a framework that is used within the Mayo Clinic to align recommendations from infectious disease experts, dental specialists, and orthopedic surgeons with regards to need for antibiotic prophylaxis prior to invasive dental procedures.

scholarly journals Designing a customized clinical practice guideline regarding antibiotic prophylaxis for Iranian general dentists

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Najmeh Savadi ◽  
Omid Barati ◽  
Hossein Mirhadi ◽  
Ali Golkari
Keyword(s):  
Clinical Practice ◽  
Antibiotic Prophylaxis ◽  
Content Validity ◽  
Expert Panel ◽  
Joint Infection ◽  
Developed Countries ◽  
Local Context ◽  
Dental Procedures ◽  
Validity Indices ◽  
General Dentists

Abstract Background Clinical practice guidelines produced by developed countries seemed to be not completely feasible for developing countries due to their different local context. In this study, we designed a customized guideline about antibiotic prophylaxis before dental procedures for Iranian general dentists. Methods This study was conducted of two parts, including a qualitative part and a cross-sectional analytic part. A multidisciplinary team searched for related guidelines and other documents, selected the most updated and high quality ones, customized their recommendations based on available antibiotics in Iran, prepared a draft adapted guideline and summarized its recommendations in 3 flowcharts. An expert panel (20 specialists of four Iranian dental universities) participated in a consensus process, afterwards to determine the relevance and clarity of the flowcharts and their items. Then the Content Validity Indices (CVIs) were calculated and any items with CVI higher than 0.79 remained. Results The adapted recommendations were summarized in flowcharts A to C. Two separate groups of patients who need antibiotic prophylaxis were presented in flowchart A; including those with high risk for distant-site infection (infective endocarditis and prosthetic joint infection) and those at risk for poor healing and orofacial infection (due to impaired immunologic function). Flowcharts B and C described antibiotic regimen and also the dental procedures where antibiotic prophylaxis was needed for mentioned groups. The content validity indices and the percentages of agreement between the expert panel members were considerably high. Conclusions A localized, clear and straight forward guideline that addresses all groups of dental patients who need antibiotic prophylaxis has been produced for Iranian general dentists.

scholarly journals DOES TOPICAL USE OF GENTAMICIN REDUCE THE INFECTION RATE IN PRIMARY TOTAL HIP ARTHROPLASTY?

2019 ◽  
Vol 27 (4) ◽  
pp. 197-201 ◽  
Author(s):  
Caio Luiz de Toledo Oliveira ◽  
Felipe Abrahão Elias ◽  
André dos Santos Ribacionka ◽  
Celso Hermínio Ferraz Picado ◽  
Flávio Luís Garcia
Keyword(s):  
Total Hip Arthroplasty ◽  
Antibiotic Prophylaxis ◽  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
University Hospital ◽  
Fisher Exact Test ◽  
Infection Rates ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

ABSTRACT Objective: To determine whether the topical use of gentamicin reduces periprosthetic joint infection rates in primary total hip arthroplasty (THA). Methods: We retrospectively evaluated two cohorts of patients who underwent primary THA in a university hospital, with a minimum of 1-year postoperative follow-up and full clinical, laboratory, and radiological documentation. Patients who underwent operation in the first 59 months of the study period (263 hips) received only intravenous cefazolin as antibiotic prophylaxis (Cef group), and those who underwent operation in the following 43 months (170 hips) received intravenous cefazolin plus topical gentamicin directly applied on the wound as antibiotic prophylaxis (Cef + Gen group). For the diagnosis of periprosthetic joint infection, we used the criteria of the Centers for Disease Control and Prevention. Data were analyzed using the Fisher exact test, and p values of <0.05 were considered significant. Results: Thirteen hips (4.9%) in the Cef group and eight hips (4.7%) in the Cef + Gen group presented periprosthetic joint infection. Statistical analysis revealed no difference between the infection rates (p = 1.0). Conclusion: Topical gentamicin as used in this study did not reduce periprosthetic joint infection rates in primary THA. Level of Evidence III, Retrospective comparative study.

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.

Antibiotic Prophylaxis in Periprosthetic Joint Infection (PJI): literature Review and World Consensus (Part Seven)

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Javad Parvizi ◽  
Mohammad Ghazavi ◽  
Members of Pre-Op Antibiotics Committee of the Consensus Meeting
Keyword(s):  
Literature Review ◽  
Antibiotic Prophylaxis ◽  
Periprosthetic Joint Infection ◽  
Joint Infection

Prosthetic Joint Infection Following Invasive Dental Procedures and Antibiotic Prophylaxis in Patients With Hip or Knee Arthroplasty

2016 ◽  
Vol 38 (2) ◽  
pp. 154-161 ◽  
Author(s):  
Feng-Chen Kao ◽  
Yao-Chun Hsu ◽  
Wen-Hui Chen ◽  
Jiun-Nong Lin ◽  
Ying-Ying Lo ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prosthetic Joint Infection ◽  
Cox Regression ◽  
Dental Treatment ◽  
Joint Infection ◽  
Prophylactic Antibiotics ◽  
Prosthetic Joint ◽  
Dental Procedures ◽  
Cohort Difference ◽  
Increased Risk

OBJECTIVESWe aimed to clarify whether invasive dental treatment is associated with increased risk of prosthetic joint infection (PJI) and whether prophylactic antibiotics may lower the infection risk remain unclear.DESIGNRetrospective cohort study.PARTICIPANTSAll Taiwanese residents (N=255,568) who underwent total knee or hip arthroplasty between January 1, 1997, and November 30, 2009, were screened.METHODSThe dental cohort consisted of 57,066 patients who received dental treatment and were individually matched 1:1 with the nondental cohort by age, sex, propensity score, and index date. The dental cohort was further divided by the use or nonuse of prophylactic antibiotics. The antibiotic and nonantibiotic subcohorts comprised 6,513 matched pairs.RESULTSPJI occurred in 328 patients (0.57%) in the dental subcohort and 348 patients (0.61%) in the nondental subcohort, with no between-cohort difference in the 1-year cumulative incidence (0.6% in both, P=.3). Multivariate-adjusted Cox regression revealed no association between dental procedures and PJI. Furthermore, PJI occurred in 13 patients (0.2%) in the antibiotic subcohort and 12 patients (0.18%) in the nonantibiotic subcohorts (P=.8). Multivariate-adjusted analyses confirmed that there was no association between the incidence of PJI and prophylactic antibiotics.CONCLUSIONSThe risk of PJI is not increased following dental procedure in patients with hip or knee replacement and is unaffected by antibiotic prophylaxis.Infect Control Hosp Epidemiol. 2017;38:154–161

Optimal Timing and Antibiotic Prophylaxis in Periprosthetic Joint Infection: Literature Review and World Consensus (Part Two)

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Javad Parvizi ◽  
Mohammad Ghazavi ◽  
Members of Pre-Op Antibiotics Committee of the Consensus Meeting
Keyword(s):  
Literature Review ◽  
Antibiotic Prophylaxis ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Optimal Timing

scholarly journals Twenty common errors in the diagnosis and treatment of periprosthetic joint infection

2019 ◽  
Vol 44 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Cheng Li ◽  
Nora Renz ◽  
Andrej Trampuz ◽  
Cristina Ojeda-Thies
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Treatment Success ◽  
Diagnostic Errors ◽  
Diagnosis And Treatment ◽  
Reactive Protein ◽  
Orthopedic Surgeons ◽  
Individualize Treatment ◽  
Infectious Disease Specialists ◽  
Multidisciplinary Teamwork

Abstract Background Misconceptions and errors in the management of periprosthetic joint infection (PJI) can compromise the treatment success. The goal of this paper is to systematically describe twenty common mistakes in the diagnosis and management of PJI, to help surgeons avoid these pitfalls. Materials and methods Common diagnostic and treatment errors are described, analyzed and interpreted. Results Diagnostic errors include the use of serum inflammatory biomarkers (such as C-reactive protein) to rule out PJI, incomplete evaluation of joint aspirate, and suboptimal microbiological procedures (such as using swabs or collection of insufficient number of periprosthetic samples). Further errors are missing possible sources of distant infection in hematogenous PJI or overreliance on suboptimal diagnostic criteria which can hinder or delay the diagnosis of PJI or mislabel infections as aseptic failure. Insufficient surgical treatment or inadequate antibiotic treatment are further reasons for treatment failure and emergence of antimicrobial resistance. Finally, wrong surgical indication, both underdebridement and overdebridement or failure to individualize treatment can jeopardize surgical results. Conclusion Multidisciplinary teamwork with infectious disease specialists and microbiologists in collaboration with orthopedic surgeons have a synergistic effect on the management of PJI. An awareness of the possible pitfalls can improve diagnosis and treatment results.

scholarly journals 1255. In Vitro Activity of Vancapticin against Methicillin-Resistant Staphylococcus aureus from Periprosthetic Joint Infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S645-S645
Author(s):  
Hye-Kyung Cho ◽  
Melissa J Karau ◽  
Kerryl E Greenwood-Quaintance ◽  
Karl A Hansford ◽  
Matthew A Cooper ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Periprosthetic Joint Infection ◽  
Mayo Clinic ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Joint Infection ◽  
Vitro Activity ◽  
In Vitro Activity ◽  
Research Support ◽  
Material Support

Abstract Background The vancapticins are modified vancomycin derivatives developed by adding membrane targeting motifs to the C-terminus of vancomycin. We determined the in vitro activity of a lead vancapticin candidate against periprosthetic joint infection-associated methicillin-resistant Staphylococcus aureus (MRSA) in the planktonic and biofilm states, and the effect of adding 0.002% polysorbate 80 (P-80; Sigma-Aldrich) on vancapticin susceptibility testing. Methods Thirty-seven clinical isolates of MRSA collected at Mayo Clinic (Rochester, Minnesota) were studied. Vancapticin minimum inhibitory concentrations (MICs) were determined using Clinical and Laboratory Standards Institutes guidelines. Minimum biofilm bactericidal concentrations (MBBCs) were determined using a pegged lid microtiter plate assay. Vancapticin MIC and MBBC values were assessed with and without P-80. Vancapticin, vancomycin, and dalbavancin biofilm time-kill assays were performed using biofilms formed by 10 MRSA isolates on Teflon coupons. Results Vancapticin MICs with and without P-80 ranged from 0.015 to 0.12 μg/mL and 0.25 to 1 μg/mL, respectively. Vancapticin MBBCs with and without P-80 ranged from 0.25 to 4 μg/mL and 1 to 8 μg/mL, respectively. Reductions of biofilm bacterial densities on Teflon coupons after 8 and 24 hours of incubation with vancapticin, vancapticin with P-80, vancomycin, or dalbavancin with P-80 were less than 3-log10 cfu/cm2 for all isolates tested. Conclusion Vancapticin has promising in vitro activity against planktonic MRSA and MRSA in a pegged lid biofilm assay, but was not bactericidal against biofilms on Teflon coupons. P-80 decreased vancapticin MICs and MBBCs. Disclosures Mark A. Blaskovich, PhD, MAB Consulting (Consultant)The University of Queensland (Employee, Grant/Research Support, Other Financial or Material Support, Inventor on patent) Robin Patel, MD, Accelerate Diagnostics (Grant/Research Support)CD Diagnostics (Grant/Research Support)Contrafect (Grant/Research Support)Curetis (Consultant)GenMark Diagnostics (Consultant)Heraeus Medical (Consultant)Hutchison Biofilm Medical Solutions (Grant/Research Support)Merck (Grant/Research Support)Next Gen Diagnostics (Consultant)PathoQuest (Consultant)Qvella (Consultant)Samsung (Other Financial or Material Support, Dr. Patel has a patent on Bordetella pertussis/parapertussis PCR issued, a patent on a device/method for sonication with royalties paid by Samsung to Mayo Clinic, and a patent on an anti-biofilm substance issued.)Selux Dx (Consultant)Shionogi (Grant/Research Support)Specific Technologies (Consultant)

scholarly journals Reducing periprosthetic joint infection: what really counts?

Joints ◽  
2015 ◽  
Vol 03 (04) ◽  
pp. 208-214 ◽  
Author(s):  
Giuseppe Solarino ◽  
Antonella Abate ◽  
Giovanni Vicenti ◽  
Antonio Spinarelli ◽  
Andrea Piazzolla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Prophylaxis ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Surgical Techniques ◽  
Joint Arthroplasty ◽  
Implant Failure ◽  
Present Review ◽  
Preoperative Period ◽  
Human Host

Periprosthetic joint infection (PJI) remains one of the most challenging complications after joint arthroplasty. Despite improvements in surgical techniques and in the use of antibiotic prophylaxis, it remains a major cause of implant failure and need for revision. PJI is associated with both human host-related and bacterial agentrelated factors that can interact in all the phases of the procedure (preoperative, intraoperative and postoperative). Prevention is the first strategy to implement in order to minimize this catastrophic complication.The present review focuses on the preoperative period, and on what to do once risk factors are fully understood and have been identified.

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