Antibiotic Stewardship in Treatment of Osteoarticular Infections Based on Local Epidemiology and Bacterial Growth Times

Vidal, Pauline; Junot, Helga; Meloni, Cyril; Bleibtreu, Alexandre; Aubry, Alexandra; Barrut, Nicolas; Clarençon, Frédéric; Daas, G; Fautrel, Bruno; Fustier, Anne; Gandjbakhch, Frédérique; Godefroy, N.; Khiami, F.; Lazennec, Jean Yves; Marchant, Maxime; Mercy, Guillaume; U, Mihaela M. I.; Monsel, Gentiane; Monzani, Quentin; Paccoud, Olivier; Rached, Brigitte; Reubrecht, Vanessa; Robert, Jérôme; Zahr, Noël

doi:10.1128/spectrum.01430-22

Cited by 2 publications

(1 citation statement)

References 49 publications

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“…Muestra actividad in-vitro sólo frente a bacterias grampositivas, aerobios y anaerobios. Su uso en Europa está aceptado desde 2003, en pacientes mayores de un año, con infecciones graves por Staphylococcus y Streptococcus β-hemolíticos, que son resistentes a otros antibióticos (6). En el caso de Enterococcus, no existe suficiente experiencia clínica y su uso no está aprobado para tratar infecciones graves por aislados resistentes a vancomicina, a diferencia de lo que ocurre en los EE.…”

Section: Introductionunclassified

Revisiting the binomial daptomycin and enterococci: ecological impact in a hospital in southeastern Spain of an antibiotic of last clinical resource

Fernández-Alonso,

Pedrosa-Corral,

Franco-Acosta

et al. 2023

an. ranm

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Background: It analyzes the evolution of the susceptibility profile to different antibiotics, including daptomycin, of isolates of Enterococcus faecium and Enterococcus faecalis from urinary cultures, together with the consumption of this antibiotic and a systematic review. Methods: Studies published before 2022 on the genetic profiles of resistance of infection-producing enterococci are reviewed, using the MEDLINE database. Urinary enterococci are described between 2012 and 2021. Information on daptomycin consumption was collected. Its relationship with non-susceptibility was analyzed, and whether the existence of this altered the susceptibility profiles to other antibiotics analyzed. Results: There is a heterogeneous group of genes that are altered when non-susceptibility to daptomycin occurs, such as the LiaFSR and YycFGHIJ systems and the enzymes Cls and GdpD, mainly involved in the response to stress in the cell membrane and in the control of the concentration of phospholipids in the membrane. It is shown that, in the case of E. faecium, there is a positive correlation between the consumption of daptomycin and the increase in non-susceptible isolates, in the same way that non-susceptibility to daptomycin is associated with alterations in the susceptibility profile of the isolates for some antibiotics, both for E. faecium and for E. faecalis. Conclusion: After the systematic review carried out, it is concluded that there are genes responsible for the lack of susceptibility to daptomycin. There is a positive correlation between the use of daptomycin and non-susceptibility, the greater the use, the greater the non-susceptibility to the antibiotic. Sensitivity profiles to other antibiotics are associated with non-susceptibility to daptomycin.

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Section: Introductionunclassified

Revisiting the binomial daptomycin and enterococci: ecological impact in a hospital in southeastern Spain of an antibiotic of last clinical resource

Fernández-Alonso,

Pedrosa-Corral,

Franco-Acosta

et al. 2023

an. ranm

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Direct Prosthetic Joint Infection Diagnosis from Sonication Fluid Inoculated in Blood Culture Bottles by Direct MALDI-TOF Mass Spectrometry

et al. 2023

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An accurate and fast microbiological diagnosis is key for a proper management and results when facing prosthetic joint infection (PJI). The purpose of this study is to assess the role of direct Matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry (MS) for early identification of the pathogens causing PJI from sonication fluid inoculated in blood culture bottles (BCB-SF). This prospective multicentric study included 107 consecutive patients from February 2016 to February 2017. Among them, 71 prosthetic joint revision surgeries were undergone for aseptic and 36 for septic reasons. Prostheses were sonicated and the resulting fluid inoculated into blood culture bottles, regardless the suspicion for infection. We assessed the diagnostic performance of direct MALDI-TOF MS identification of the pathogens in BCB-SF and compared it with periprosthetic tissue and conventional sonication fluid cultures. The sensitivity of direct MALDI-TOF MS of BCB-SF (69%) was higher compared to conventional sonication fluid (69% vs. 64%, p > 0.05) or intraoperative tissue cultures (69% vs. 53%, p = 0.04), especially for patients receiving antimicrobial treatment. This approach also reduced the time for identification but the specificity was compromised (100% vs. 94%) and polymicrobial infections were missed. In conclusion, BCB-SF improves the sensitivity and reduces the time of PJI diagnosis when used in combination with conventional cultures under strict sterility conditions.

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Antibiotic Stewardship in Treatment of Osteoarticular Infections Based on Local Epidemiology and Bacterial Growth Times

Abstract: Osteoarticular infections (OAI) remain challenging to diagnose and to treat. One of the issues concerns postoperative empirical antimicrobial therapy (EAT), which is usually a combination of broad-spectrum antibiotics.

Cited by 2 publications

References 49 publications

Revisiting the binomial daptomycin and enterococci: ecological impact in a hospital in southeastern Spain of an antibiotic of last clinical resource

Revisiting the binomial daptomycin and enterococci: ecological impact in a hospital in southeastern Spain of an antibiotic of last clinical resource

Direct Prosthetic Joint Infection Diagnosis from Sonication Fluid Inoculated in Blood Culture Bottles by Direct MALDI-TOF Mass Spectrometry

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