scholarly journals Diagnostični protokol za obravnavo okuženih sklepnih vsadkov

2015 ◽  
Vol 84 (6) ◽  
Author(s):  
Alen Mlekuž ◽  
Rihard Trebše ◽  
Rene Mihalič ◽  
Vesna Levašič
Keyword(s):  
Absolute Number ◽  
Low Grade ◽  
Joint Infections ◽  
Orthopedic Surgeons ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Early Failures ◽  
Increased Sensitivity ◽  
To Come ◽  
Ongoing Infection

Infection is becoming the most important as well as the most devastating mechanism of prosthetic joint failure. The incidence is increasing due to increased sensitivity of orthopedic surgeons for this diagnosis, better diagnostics, and  because the absolute number of operated patients is increasing and because more often very sick, debilitated, and immunocompromised patients are operated on. The trend shows the incidence to further increase in the years to come. The diagnosis may be very easy in case of high grade processes, but also extremely difficult in low grade infections. Misdiagnosing infection leads to repeat early failures and revisions that are distressing for patients as well as for surgeons. To avoid failures related to misdiagnosed prosthetic joint infections a step-wise algorithm of action is proposed and the diagnostic strength of the steps discussed. The key point is to select the potential candidates to define the possibility of an ongoing infection and then to select the tools to strengthen the suspicion. The further procedures base on the analysis of the pseudo-synovial fluid obtained by aspiration. The diagnostic conclusions form the basis for considered treatment decisions.

Detection of low-grade prosthetic joint infections using 99mTc-antigranulocyte SPECT/CT: initial clinical results

2010 ◽  
Vol 37 (9) ◽  
pp. 1751-1759 ◽  
Author(s):  
Vera Graute ◽  
Markus Feist ◽  
Sebastian Lehner ◽  
Alexander Haug ◽  
Peter Ernst Müller ◽  
...  
Keyword(s):  
Clinical Results ◽  
Low Grade ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

scholarly journals Experience With the Use of the MicroDTTect Device for the Diagnosis of Low-Grade Chronic Prosthetic Joint Infections in a Routine Setting

2021 ◽  
Vol 8 ◽  
Author(s):  
Camille Kolenda ◽  
Jérôme Josse ◽  
Cécile Batailler ◽  
Allison Faure ◽  
Alice Monteix ◽  
...  
Keyword(s):  
Treatment Time ◽  
Prosthetic Material ◽  
Low Grade ◽  
Microbiological Diagnosis ◽  
Conventional Culture ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Cutibacterium Acnes ◽  
Commercial Device

Background: In prosthetic joint infections (PJIs), identification of the causative microorganisms is critical to successfully adapt and optimize treatment. However, microbiological diagnosis of PJIs remains a challenge notably because bacteria are embedded in biofilm adhered to the prosthetic material. Recently, dithiothreitol (DTT) treatment of prosthesis has been proposed as a new strategy to release bacteria from biofilm and to improve the yield of microbiological diagnosis. In this study, we evaluated the interest of a commercial device using DTT, the MicroDTTect system (Heraeus, Hanau, Germany), for the diagnosis of low-grade chronic PJIs, compared to the conventional culture of periprosthetic tissue (PPT) samples.Methods: Twenty patients undergoing a surgery procedure for removal of prosthetic material because of a suspicion of low-grade PJI without pre-operative microbiological documentation were included (NCT04371068). Bacteriological results using the fluid obtained after prosthesis treatment with the MicroDTTect system were compared to results obtained with conventional culture of PPT samples.Results: All the bacteria considered as responsible for PJIs recovered from culture of PPT samples were also detected using the MicroDTTect device. For one patient, an additional bacterial isolate (Staphylococcus haemolyticus) suspected to be involved in a polymicrobial PJI was identified using DTT treatment. Time to positivity of the cultures was also reduced using the MicroDTTect system, notably in case of Cutibacterium acnes infection. However, probable bacterial contaminants were found (MicroDTTect system, n = 5; PPT samples, n = 1).Conclusion: This study showed that DTT treatment of the prosthetic component using the MicroDTTect device could improve the microbiological diagnosis of low-grade PJIs.

scholarly journals Staphylococcus saccharolyticus Associated with Prosthetic Joint Infections: Clinical Features and Genomic Characteristics

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 397
Author(s):  
Bo Söderquist ◽  
Mastaneh Afshar ◽  
Anja Poehlein ◽  
Holger Brüggemann
Keyword(s):  
Aseptic Loosening ◽  
Normal Skin ◽  
Low Grade ◽  
Pathogenic Potential ◽  
Long Term Outcome ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Cutibacterium Acnes

The anaerobic coagulase-negative staphylococcal species Staphylococcus saccharolyticus is a member of the normal skin microbiota. However, S. saccharolyticus is rarely found in clinical specimens and its pathogenic potential is unclear. The clinical data of prosthetic hip (n = 5) and shoulder (n = 2) joint implant-associated infections where S. saccharolyticus was detected in periprosthetic tissue specimens are described. The prosthetic hip joint infection cases presented as “aseptic” loosening and may represent chronic, insidious, low-grade prosthetic joint infections (PJIs), eventually resulting in loosening of prosthetic components. All cases were subjected to one-stage revision surgery and the long-term outcome was good. The shoulder joint infections had an acute onset. Polymicrobial growth, in all cases with Cutibacterium acnes, was found in 4/7 patients. All but one case were treated with long-term administration of beta-lactam antibiotics. Whole-genome sequencing (WGS) of the isolates was performed and potential virulence traits were identified. WGS could distinguish two phylogenetic clades (clades 1 and 2), which likely represent distinct subspecies of S. saccharolyticus. Little strain individuality was observed among strains from the same clade. Strains of clade 2 were exclusively associated with hip PJIs, whereas clade 1 strains originated from shoulder PJIs. It is possible that strains of the two clades colonize different skin habitats. In conclusion, S. saccharolyticus has the potential to cause PJIs that were previously regarded as aseptic loosening of prosthetic joint devices.

Review of Guidelines for Dental Antibiotic Prophylaxis for Prevention of Endocarditis and Prosthetic Joint Infections and Need for Dental Stewardship

2019 ◽  
Vol 71 (2) ◽  
pp. 455-462 ◽  
Author(s):  
Debra A Goff ◽  
Julie E Mangino ◽  
Andrew H Glassman ◽  
Douglas Goff ◽  
Peter Larsen ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Private Practice ◽  
Heart Association ◽  
Dental Procedure ◽  
Community Based ◽  
Joint Replacements ◽  
Joint Infections ◽  
Orthopedic Surgeons ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Abstract Dentists prescribe 10% of all outpatient antibiotic prescriptions, writing more than 25.7 million prescriptions per year. Many are for prophylaxis in patients with prosthetic joint replacements; the American Dental Society states that “in general,” prophylactic antibiotics are not recommended to prevent prosthetic joint infections. Orthopedic surgeons are concerned with the risk of implant infections following a dental procedure and, therefore, see high value and low risk in recommending prophylaxis. Patients are “stuck in the middle,” with conflicting recommendations from orthopedic surgeons (OS) and dentists. Unnecessary prophylaxis and fear of lawsuits amongst private practice dentists and OS has not been addressed. We review The American Heart Association/American College of Cardiology, American Dental Association, and American Association of Orthopedic Surgeons’ guidelines on dental antibiotic prophylaxis for the prevention of endocarditis and prosthetic joint infections. We provide experience on how to engage private-practice dentists and OS in dental stewardship using a community-based program.

scholarly journals C-reactive protein may misdiagnose prosthetic joint infections, particularly chronic and low-grade infections

2017 ◽  
Vol 41 (7) ◽  
pp. 1315-1319 ◽  
Author(s):  
Daniel Pérez-Prieto ◽  
María E. Portillo ◽  
Lluís Puig-Verdié ◽  
Albert Alier ◽  
Santos Martínez ◽  
...  
Keyword(s):  
Low Grade ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections
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