No need to search for the source of haematogenous arthroplasty infections

Bouvet, Cindy; Tchernin, David Laurent; Seirafi, Mariam; Stern, Richard; Lew, Daniel Pablo; Hoffmeyer, Pierre; Uçkay, İlker

doi:10.4414/smw.2011.13306

Cited by 7 publications

(6 citation statements)

References 12 publications

(23 reference statements)

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“…Eleven patients were intravenous drug abusers. In 148 episodes, the origin remained unknown despite intensive workup [25]. In 105 cases, patients were already under 35 different antibiotic regimens during joint sampling.…”

Section: Study Populationmentioning

confidence: 99%

Gram and acridine orange staining for diagnosis of septic arthritis in different patient populations

Cunningham

Seghrouchni

Ruffieux

et al. 2014

International Orthopaedics (SICOT)

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Section: Study Populationmentioning

confidence: 99%

Gram and acridine orange staining for diagnosis of septic arthritis in different patient populations

Cunningham

Seghrouchni

Ruffieux

et al. 2014

International Orthopaedics (SICOT)

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“…This is in agreement with the latest recommendations to avoid antibiotic prophylaxis in dental or endoscopic procedures [ 18 , 20 ]. Moreover, the fact that 70% percent of the patients with an unknown foci LAH PJI have been cured may suggest that identification and a extensive work-up may not be needed except for very specific cases such as Streptococcus bovis or Gemella morbillorum and their relationship with intestinal tumors [ 3 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence, functional outcomes and cure rate of hematogenous infection in a 2,498 Total Knee Arthroplasties cohort

Pérez‐Prieto,

Pardo,

Fontanellas

et al. 2023

J. exp. orthop.

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Purpose The primary aim of the present study is to report the late acute hematogenous (LAH) prosthetic joint infection (PJI) cure rate following Total knee arthroplasty (TKA) treated by means of debridement, antibiotics, and implant retention (DAIR) in a long-term follow-up. The secondary purpose is to report the functional outcomes at that follow-up and to compare them with a non-infected group. Material and Methods This study cohort consists of 2,498 TKA performed from September 2005 to April 2010 that had a minimum follow-up of 10 years. The diagnosis of PJI and classification into LAH was done in accordance with the Zimmerli criteria. The primary outcome was the failure rate, defined as death before the end of antibiotic treatment, a further surgical intervention for treatment of infection, life-long antibiotic suppressive treatment or chronic infection. The Knee Society Score (KSS) was used to evaluate clinical outcomes. Results Ten patients were diagnosed with acute hematogenous PJI during the study period (0.4%). All of them were managed with DAIR, which was performed by a knee surgeon and/or PJI surgeon. The failure rate was 0% at the 8.5-year (SD, 2.4) follow-up mark. The KSS score was 82.1 vs. 84.1 (p n.s.) at final follow-up. Conclusion Although the literature suggests that TKA DAIR for LAH periprosthetic joint infection is associated with high rates of failure, the results presented here suggest a high cure rate with good functional outcomes. Level of evidence Level II, prospective cohort study.

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“…Studies have reported that the infection rate of hip and knee prosthesis is 1.9%, while the infection rate of open fracture xation is as high as more than 60% 2,3 . Staphylococcus aureus bacteremia is the primary cause of internal plant infections, but the study of Bouvet et al Show that the proportion of Gram-negative bacilli infection is higher than that of Gram-positive bacilli 2 years after implant 4,5 . Moreover, Escherichia coli is the primary cause of gram-negative bacteria IRI 5,6 .…”

Section: Introductionmentioning

confidence: 99%

“…Staphylococcus aureus bacteremia is the primary cause of internal plant infections, but the study of Bouvet et al Show that the proportion of Gram-negative bacilli infection is higher than that of Gram-positive bacilli 2 years after implant 4,5 . Moreover, Escherichia coli is the primary cause of gram-negative bacteria IRI 5,6 . The pathogenesis of IRI is complex and the treatment is extremely di cult.…”

Section: Introductionmentioning

confidence: 99%

“…Different from Shirai et al [18][19][20][21] ,we have developed an iodine-coated titanium implant by electrophoretic deposition method 22,23 , which was veri ed to have clear antibacterial properties against Staphylococcus aureus by in experiments. However, at present, neither of the two iodine-coated titanium implants has carried out in vivo antibacterial experiments against Gram-negative bacteria.Gram-negative bacteria infections are also common in clinical orthopedics [4][5][6] .In this study, we will conduct an in vivo study on the antibacterial activity of titaniumcoated implants against Gram-negative bacteria by constructing an acute osteomyelitis model.…”

Section: Introductionmentioning

confidence: 99%

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Experimental Study On Antibacterial Properties of Iodine-Coated Implant in Acute Osteomyelitis Model

Zhuang

Yang

Zhang

et al. 2021

Preprint

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Purpose We have developed a iodine-coated implant and evaluated its antibacterial properties against Gram-negative bacteria by constructing an experimental osteomyelitis model.Methods In this study, 16 titanium Kirschner-wires were selected, of which 8 titanium K-wires were treated with iodine on the surface by electrophoretic deposition with PVP-I solution. In our study, the standard strain of Escherichia coli (ATCC 25922) was selected, and 16 New Zealand rabbits were selected. There were 8 rabbits in the iodine-coated group and 8 rabbits in the non-iodine-coated group. All animals were drilled in the left proximal tibia after successful anesthesia.After that,the iodine-coated group was implanted with iodine-coated titanium K-wires.Then, 25ul of 2×108CFU/ml bacterial suspension was injected into the bone marrow cavity with pipette gun, and the bone hole was sealed with bone wax.They were reared in cages for 1 week after operation, and evaluated and analyzed by microbiology, histopathology, scanning electron microscopy, etc.Results The results of gross wound score and microbiology showed that the wound infection of the iodine-coated group was less severe than that of the non-iodine-coated group, which was confirmed by the histopathological results. Scanning electron microscopy and confocal microscopy showed that the amount of bacteria on the surface of iodine-coated K-wires was significantly lower than that non-iodine-coated K-wires. Conclusions In this study, we have verified that the iodine-coated titanium implant could effectively inhibit E. coli infection in the early stage of infection by constructing an acute osteomyelitis model.

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No need to search for the source of haematogenous arthroplasty infections

Abstract: From an epidemiologic point of view, patient history is the best way to predict the origin of PJI. Blind additional radiographic or endoscopic exams are costly, inconclusive and do not contribute to the management of these cases.

Cited by 7 publications

References 12 publications

Gram and acridine orange staining for diagnosis of septic arthritis in different patient populations

Gram and acridine orange staining for diagnosis of septic arthritis in different patient populations

Incidence, functional outcomes and cure rate of hematogenous infection in a 2,498 Total Knee Arthroplasties cohort

Experimental Study On Antibacterial Properties of Iodine-Coated Implant in Acute Osteomyelitis Model

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