scholarly journals Prosthetic Knee Septic Arthritis due toPseudomonas stutzeri

2000 ◽  
Vol 11 (6) ◽  
pp. 329-331 ◽  
Author(s):  
Jihad Bishara ◽  
Eyal Robenshtok ◽  
Zmira Samra ◽  
Silvio Pitlik
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Pseudomonas Stutzeri ◽  
Promyelocytic Leukemia ◽  
Artificial Joint ◽  
Coagulase Negative Staphylococci ◽  
Pertinent Literature ◽  
Prosthetic Knee ◽  
Prosthetic Joint ◽  
Artificial Joint Replacement

Prosthetic joint infection is usually caused byStaphylococcus aureus, coagulase-negative staphylococci and, less commonly, by Gram-negative bacilli and anaerobes. A case of prosthetic joint infection due toPseudomonas stutzeriin a 73-year-old female with acute promyelocytic leukemia is presented, and the pertinent literature is reviewed. Although the patient had prolonged neutropenia, the infection was successfully treated with antibiotics and without artificial joint replacement.

Diagnostic accuracy of alpha-defensin enzyme-linked immunosorbent assay in the clinical evaluation of painful hip and knee arthroplasty with possible prosthetic joint infection

2019 ◽  
Vol 101-B (8) ◽  
pp. 970-977 ◽  
Author(s):  
S. Kleiss ◽  
N. M. Jandl ◽  
A. Novo de Oliveira ◽  
W. Rüther ◽  
A. Niemeier
Keyword(s):  
Synovial Fluid ◽  
Diagnostic Accuracy ◽  
Immunosorbent Assay ◽  
Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Coagulase Negative Staphylococci ◽  
Predictive Values ◽  
Prosthetic Joint

Aims The aim of this study was to evaluate the diagnostic accuracy of the synovial alpha-defensin enzyme-linked immunosorbent assay (ELISA) for the diagnosis of prosthetic joint infection (PJI) in the work-up prior to revision of total hip (THA) and knee arthroplasty (TKA). Patients and Methods Inclusion criteria for this prospective cohort study were acute or chronic symptoms of the index joint without specific exclusion criteria. Synovial fluid aspirates of 202 patients were analyzed and semiquantitative laboratory alpha-defensin ELISA was performed. Final diagnosis of PJI was established by examination of samples obtained during revision surgery. Results Sensitivity and specificity of the alpha-defensin ELISA for PJI were 78.2% (95% confidence interval (CI) 66.7 to 88.5) and 96.6% (95% CI 93.0 to 99.3). Positive and negative predictive values were 89.6% (95% CI 80.6 to 97.8) and 92.2% (95% CI 87.5 to 96.1). The test remained false-negative in 22% of septic revisions, most of which were due to coagulase-negative staphylococci all occurring in either late-chronic or early-postoperative PJI. Conclusion The routine use of synovial fluid alpha-defensin laboratory ELISA in the preoperative evaluation of symptomatic THAs and TKAs is insufficient to accurately diagnose PJI. Particularly in cases involving low-virulence organisms, such as coagulase-negative staphylococci, there remains a need for tests with a higher sensitivity. Cite this article: Bone Joint J 2019;101-B:970–977.

scholarly journals Microbiological Epidemiology Depending on Time to Occurrence of Prosthetic Joint Infection (PJI): Impact on the Empirical Antimicrobial Strategies

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S95-S96
Author(s):  
Tristan Ferry ◽  
Claire Triffault-Fillit ◽  
Frederic Laurent ◽  
Céline Dupieux ◽  
Sébastien Lustig ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Coagulase Negative Staphylococci ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Lactam Antibiotic ◽  
Revision Prosthesis ◽  
Current Guidelines ◽  
Microbiological Data

Abstract Background Empirical antimicrobial therapy of prosthetic-joint infection (PJI) is a major clinical challenge and current guidelines recommend the combination of vancomycin plus a broad-spectrum β-lactamin. As Gram-negative bacilli (GNB) are probably less represented in late infections, we evaluate the microbiological epidemiology in patients with PJI according to the chronology of infection. Methods All patients managed in a reference center for complex bone and joint infections in France (2011 and 2016) were included in a prospective cohort study. Microbiological data at the time of diagnosis were collected and analyzed according to the chronology of infection. Results We included 567 PJI (284 males, 50.1%; median age 70.3 years). The median occurrence time was 23.4 weeks after prosthesis implantation (285 hip and 255 knee PJI, which were revision prosthesis in 216 [40.3%] cases). Microbiological bone samples found 164 [28.9%] S. aureus (including 26 [16.3%] MRSA), 162 [28.6%] coagulase-negative Staphylococci (CoNS, including 80 [58.8%] methicillin-resistant CoNS), 80 (14.1%) Enterobacteriaceae, 74 (13.1%) Streptococci, and 85 (15.0%) anaerobes (including 60 [10.6%] Propionibacterium). Infection was plurimicrobial in 10 [18.2%] cases. Among the 183 patients (32%) with late PJI (occurring >1 year), obtained after exclusion of the 59 patients (10.4%) with hematogenous origins, Enterobacteriacecae 
(n = 8; 4.4%; P < 10–3) were much less represented than in patients with early PJI occurring <1 year. No difference was observed regarding the the presence of non-fermenting GNB, with a prevalence of 4.6 and 2.7% in early and late PJI, respectively. Taken together, these data suggest that a broad-spectrum β-lactam antibiotic might be useful in only 12 (6.6%) patients with late PJI, compared with 66 (20.3%) patients with early PJI (P < 10–3). Of note, there were statistically more anaerobes (n = 40; 21.9%) in late PJI, including 32 Propionibacterium (17.5%; P < 10–3). Conclusion Considering the minority amount of GNB in late post-operative PJI and the overrepresentation of anaerobes including P. acnes, the empirical treatment should be reconsidered, especially when a two-stage exchange is planned. In those situations, another acceptable option could be the vancomycin+clindamycin combination. Disclosures T. Ferry, HERAEUS: Consultant, Speaker honorarium. S. Lustig, Heraeus: Consultant, Consulting fee.

scholarly journals Pseudomonas stutzeri prosthetic joint infection: a therapeutic challenge associated with multiple severe complications

2020 ◽  
Vol 33 (3) ◽  
pp. 218-220
Author(s):  
David Alonso Menchén ◽  
José María Barbero Allende ◽  
Javier Balsa Vázquez ◽  
Carlos Ignacio Jacob García-Asenjo ◽  
Guiomar Hernández García ◽  
...  
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Pseudomonas Stutzeri ◽  
Therapeutic Challenge ◽  
Prosthetic Joint

scholarly journals Chronic prosthetic joint infection caused by Listeria monocytogenes

2009 ◽  
Vol 58 (1) ◽  
pp. 138-141 ◽  
Author(s):  
Peter Kleemann ◽  
Eugen Domann ◽  
Trinad Chakraborty ◽  
Irene Bernstein ◽  
Michael Lohoff
Keyword(s):  
Listeria Monocytogenes ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Knee ◽  
First Case ◽  
Prosthetic Joint ◽  
Device Infection

We report what is to the best of our knowledge the first case of persistent human listeriosis. A housewife underwent excision of a leiomyosarcoma and implantation of a prosthetic knee device. Infection of the device with Listeria monocytogenes occurred and persisted for 2 years. Despite having an allergy to ampicillin, the patient was cured solely by antibiotics and without surgery.

scholarly journals Infection of a prosthetic knee joint with Clostridium bifermentans

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Lisa F Barrett ◽  
Sailaja Devi Saragadam ◽  
Christina N DiMaria ◽  
Alejandro Delgado-Daza
Keyword(s):  
Soft Tissue ◽  
Knee Joint ◽  
Septic Arthritis ◽  
Soft Tissue Infection ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Knee ◽  
Prosthetic Joint ◽  
Clostridium Bifermentans ◽  
Prosthetic Knee Joint

ABSTRACT We present the first reported case of prosthetic joint infection caused by Clostridium bifermentans, which was treated with total joint washout and debridement allowing for the patient to retain his prosthesis and achieve full recovery. Clostridium bifermentans is a gram-positive, anaerobic, spore-forming bacterium. This organism was once considered to be non-pathogenic, but has recently been associated with cases of septic arthritis, empyema, osteomyelitis, soft tissue infection, brain abscess, bacteremia and endocarditis.

scholarly journals Microbiological Aetiology, Epidemiology, and Clinical Profile of Prosthetic Joint Infections: Are Current Antibiotic Prophylaxis Guidelines Effective?

2012 ◽  
Vol 56 (5) ◽  
pp. 2386-2391 ◽  
Author(s):  
Trisha N. Peel ◽  
Allen C. Cheng ◽  
Kirsty L. Buising ◽  
Peter F. M. Choong
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Content Type ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Surgical Antibiotic Prophylaxis

ABSTRACTProsthetic joint infections remain a major complication of arthroplasty. At present, local and international guidelines recommend cefazolin as a surgical antibiotic prophylaxis at the time of arthroplasty. This retrospective cohort study conducted across 10 hospitals over a 3-year period (January 2006 to December 2008) investigated the epidemiology and microbiological etiology of prosthetic joint infections. There were 163 cases of prosthetic joint infection identified. From a review of the microbiological culture results, methicillin-resistantStaphylococcus aureus(MRSA) and coagulase-negative staphylococci were isolated in 45% of infections. In addition, polymicrobial infections, particularly those involving Gram-negative bacilli and enterococcal species, were common (36%). The majority (88%) of patients received cefazolin as an antibiotic prophylaxis at the time of arthroplasty. In 63% of patients in this cohort, the microorganisms subsequently obtained were not susceptible to the antibiotic prophylaxis administered. The results of this study highlight the importance of ongoing reviews of the local ecology of prosthetic joint infection, demonstrating that the spectrum of pathogens involved is broad. The results should inform empirical antibiotic therapy. This report also provokes discussion about infection control strategies, including changing surgical antibiotic prophylaxis to a combination of glycopeptide and cefazolin, to reduce the incidence of infections due to methicillin-resistant staphylococci.

Sign in / Sign up

Export Citation Format

Share Document