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Journal of Bone and Joint Infection

Zida Huang, Chongjing Zhang, Wenbo Li, Xinyu Fang, Qijin Wang, Li Xing, Yingzhen Li, Xifang Nie, Bin Yang, Wenming Zhang
Identifying fastidious pathogens in patients with prosthetic joint infection (PJI) by culture is challenging. Metagenomic next-generation sequencing (mNGS) is a novel culture-independent approach that is associated with a higher likelihood for identifying pathogens. We present a case where mNGS was implemented to identify Parvimonas micra , a rarely reported and difficult-to-culture PJI pathogen.
2019: Journal of Bone and Joint Infection
Musa Zaid, Madisyn R Chavez, Adrianna E Carrasco, Melissa N Zimel, Alan L Zhang, Andrew E Horvai, Thomas M Link, Richard J O'Donnell
Cutibacterium (formerly Propionibacterium ) acnes13, 16 is a slow growing, gram-positive bacteria that is naturally found in higher concentrations as skin flora on the chest and back, as well as in other areas with greater numbers of hair follicles.25, 37 Most of the reported cases of C. acnes shoulder girdle infection follow arthroplasty surgery,18, 20, 26, 27, 32, 35 which then often requires debridement, administration of intravenous antibiotics, and surgical revision of the implanted device.12, 15, 21, 28-30 In a recent study, 56% of 193 shoulder revisions had a positive culture, 70% of which grew C...
2019: Journal of Bone and Joint Infection
Niels van der Naald, Diederik P J Smeeing, Roderick M Houwert, Falco Hietbrink, Geertje A M Govaert, Detlef van der Velde
Introduction: Brodie's abscess is a form of osteomyelitis. Since its first appearance in the medical literature in 1832, numerous cases have been described. The aim of this article is to provide the first comprehensive overview of published cases of Brodie's abscess, and to describe diagnostic methods, therapeutic consequences and outcomes. Methods: According to PRISMA guidelines a systematic review of the literature was performed. All published data in English or Dutch were considered for inclusion with no limitations on publication date...
2019: Journal of Bone and Joint Infection
Martí Bernaus, Francesc Anglès, Berta Escudero, Margarita Veloso, Alfredo Matamala, Lluís Font-Vizcarra
Objectives: Obesity is a documented comorbidity that is prevalent in the elderly population and a known predictor for surgical site infection (SSI). Body mass index is a convenient method to classify obesity, but it fails to account for fat distribution. The objective of our study was to evaluate the association between surgical site infection and a subcutaneous radiographic measurement (SRM) in elderly hip fracture patients. Materials and Methods: A retrospective case-control study was conducted to compare SRMs at the hip in patients diagnosed with surgical site infection after hip fracture surgery with patients that were not diagnosed with surgical site infection...
2019: Journal of Bone and Joint Infection
Merit P George, Floranne C Ernste, Aaron Tande, Douglas Osmon, Tad Mabry, Elie F Berbari
Introduction: Calcium pyrophosphate deposition disease (CPPD), or pseudogout, is rare in prosthetic joints, but can mimic prosthetic joint infection (PJI) according to case reports. The purpose of this case series is to describe the demographics, presentation, management, and outcomes of a cohort of these patients seen at our academic medical center. Methods: Patients with post-implant pseudogout, who were evaluated at our medical center between January 1, 2000 and June 30, 2016, were identified from our EHR...
2019: Journal of Bone and Joint Infection
Staffan Tevell, Sharmin Baig, Åsa Nilsdotter-Augustinsson, Marc Stegger, Bo Söderquist
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.
2019: Journal of Bone and Joint Infection
Cornelis M Vincenten, Brenda L Den Oudsten, Pieter K Bos, Stefan B T Bolder, Taco Gosens
Introduction: The Girdlestone resection arthroplasty (GRA) is a salvage procedure for a recurrent or persistent prosthetic joint infection of the hip. This procedure negatively impacts the functional outcome and presumably also diminishes health status (HS) and quality of life (QOL). However, studies investigating the QOL after GRA are lacking. This cross-sectional study compares patients with a Girdlestone situation after an infected total hip prosthesis with a normative population with regard to HS and QOL...
2019: Journal of Bone and Joint Infection
Vajra Badha, Rex Moore, John Heffernan, Paulo Castaneda, Alex McLaren, Derek Overstreet
Background : Bacterial biofilms cause chronic orthopaedic infections. Surgical debridement to remove biofilm can be ineffective without adjuvant local antimicrobials because undetected biofilm fragments may remain in the wound and reestablish the infection if untreated. However, the concentrations and duration of antimicrobial exposure necessary to eradicate bacteria from clinical biofilms remain largely undefined. In this study, we determined the minimum biofilm eradication concentration (MBEC) of tobramycin and vancomycin for bacterial biofilms grown on bone and muscle in vitro ...
2019: Journal of Bone and Joint Infection
Cheng Li, Nora Renz, Cristina Ojeda Thies, Andrej Trampuz
Introduction: Periprosthetic joint infection (PJI) is the most serious complication after arthroplasty, and the diagnosis of PJI is still challenging with modern medical technology. To improve the diagnostic rate, combined diagnostic methods are gradually beginning to be used to diagnose PJI. Sonication is one accurate way to diagnose PJI, but there is minimal research regarding the diagnostic value of sonicate fluid (SF) in blood culture bottles (BCB). Therefore, we evaluated this combined diagnostic method by meta-analysis...
2018: Journal of Bone and Joint Infection
Romain Manet, Tristan Ferry, Jean-Etienne Castelain, Gilda Pardey Bracho, Eurico Freitas-Olim, Jacqueline Grando, Cédric Barrey
Introduction: Management of surgical site infections (SSI) after instrumented spinal surgery remains controversial. The debridement-irrigation, antibiotic therapy and implant retention protocol (DAIR protocol) is safe and effective to treat deep SSI occurring within the 3 months after instrumented spinal surgery. Methods: This retrospective study describes the outcomes of patients treated over a period of 42 months for deep SSI after instrumented spinal surgery according to a modified DAIR protocol. Results: Among 1694 instrumented surgical procedures, deep SSI occurred in 46 patients (2...
2018: Journal of Bone and Joint Infection
Marianne Westberg, Bjarne Grøgaard, Finnur Snorrason
Background: To report incidence, microbiological findings, and treatment outcome of prosthetic joint infection (PJI) after constrained condylar knee arthroplasty. Methods: Retrospective study of 100 consecutive complex primary and revision total knee arthroplasties operated with constrained condylar knee arthroplasties between February 2006 and October 2015 at a single institution. Demographic and surgical data were registered, as well as data regarding infection, microbiology and treatment. Follow-up median 43 months; SD 32...
2018: Journal of Bone and Joint Infection
Parham Sendi, Andreas M Müller, Elie Berbari
No abstract text is available yet for this article.
2018: Journal of Bone and Joint Infection
Stéphane Corvec, Aurélie Guillouzouic, Guillaume Ghislain Aubin, Sophie Touchais, Olivier Grossi, François Gouin, Pascale Bémer
After rifampin and levofloxacin treatment for a Staphylococcus aureus bone infection, a pyogenic granuloma due to a newly described Cutibacterium species, C. namnetense developed on the tibia former external fixator. This rifampin resistant bacterium, selected during treatment, harbored a mutation in the rpoB gene. This case illustrates the possible in vivo selection of resistant mutant most likely due to the bacterial burden and therefore the importance of adequate bone infection treatment.
2018: Journal of Bone and Joint Infection
Arnaud Fischbacher, Karine Peltier, Olivier Borens
Background: There is a constant increase of joint arthroplasties performed, with an infectious risk of 1-2%. Different therapeutic options for prosthetic-joint infections exist, but surgery remains essential. With a two-stage exchange procedure, a success rate above 90% can be expected. Currently, there is no consensus regarding the optimal interval duration between explantation and reimplantation. This retrospective study aimed to assess the economic impact of a two-stage exchange from a single-hospital perspective...
2018: Journal of Bone and Joint Infection
Carol Strahm, Vilijam Zdravkovic, Claus Egidy, Bernhard Jost
Joint aspiration in suspected infected implants is a validated diagnostic method in establishing the diagnosis of prosthetic joint infection (PJI). Cut-off values for synovial leukocyte counts and differentials are well described for patients with hip and knee PJI. In 19 failed shoulder implants, a leucocyte count of >12.2 G/L had a sensitivity and specificity of 92% and 100% respectively; A differential of >54% neutrophils had a sensitivity of 100 % and a specificity of 75%.
2018: Journal of Bone and Joint Infection
Fernanda Medina, Vanina Meyssonnier, Valérie Zeller, Beate Heym, Jean-Marc Ziza, Simon Marmor
Introduction: Prosthetic joint infections (PJIs) can be acquired hematogenously from a distant site or device. Notably, 30%-40% of patients with PJIs have Staphylococcus aureus bacteremia. No case reports or series of PJIs acquired from totally implantable venous-access device (TIVAD) infection or colonization have been published. This study was undertaken to describe epidemiological, clinical, microbiological and radiological characteristics of such PJIs, their treatments and outcomes. Methods: This retrospective study included all patients, identified in a prospective French Bone-and-Joint Infections Referral Center cohort treated between 2004 and 2017, with PJI secondary to TIVAD infection, with the same microbiologically documented microorganism isolated from both...
2018: Journal of Bone and Joint Infection
Thomas Colding-Rasmussen, Peter Horstmann, Michael Mørk Petersen, Werner Hettwer
Introduction: Locally implanted antibiotic-eluting carriers may be a valuable adjuvant to the management of prosthetic joint infections. Aim: to assess local and plasma antibiotic concentrations as well as cumulative antibiotic urine excretion associated with clinical use of a gentamicin - or vancomycin-loaded mineral composite antibiotic carrier. Methods: 32 patients (male/female=19/13, mean age=56; 21-82 years) were prospectively followed after implantation of gentamicin (n=11), vancomycin (n=15), or a combination (n=7), using an antibiotic carrier (CERAMENT™|G or CERAMENT™|V, mean amount 11 (3-20) mL) during resection arthroplasty of the hip/knee...
2018: Journal of Bone and Joint Infection
Joanna Kedra, Valérie Zeller, Beate Heym, Philippe Lehours, Vanina Meyssonnier, Sylvie Lariven, Lucie Bruhl-Bénéjat, Simon Marmor, Jean-Marc Ziza
We describe the case of an HIV-infected man who developed twice a Helicobacter cinaedi prosthetic joint infection. In our knowledge, it is the first case to date. Furthermore, it illustrates the fact that this bacterium is difficult to isolate and that recurrences can occur even after apparently successful treatment.
2018: Journal of Bone and Joint Infection
Markus Rupp, Gero Knapp, David Weisweiler, Christian Heiss, Volker Alt
Necrotizing fasciitis is an uncommon but often fatal disease. Given the various causes of necrotizing fasciitis, we report a case of sigmoid colon perforation caused by a toothpick subsequently resulting in fulminant necrotizing fasciitis of the retroperitoneum and right thigh successfully treated by hemipelvectomy and Hartmann´s procedure.
2018: Journal of Bone and Joint Infection
Marjan Wouthuyzen-Bakker, Jaime Lora-Tamayo, Eric Senneville, Matthew Scarbourough, Tristan Ferry, Ilker Uçkay, Mauro J Salles, Karina O'Connell, Josean A Iribarren, Dace Vigante, Rihard Trebse, Cedric Arvieux, Alex Soriano, Javier Ariza
We describe a case of a 60-year old male who developed an acute prosthetic joint infection (PJI) of the knee, secondary to erysipelas of the lower leg due to beta-hemolytic Group G streptococci. As it is unknown how often this phenomenon occurs in patients with prosthetic implants and which patients are most prone to develop this complication, we analyzed: i) the incidence of the development of a PJI in these patients and ii) the clinical characteristics of streptococcal PJI during an episode of erysipelas/cellulitis...
2018: Journal of Bone and Joint Infection
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