scholarly journals The Role of Oral Antibiotic Treatment in Prosthetic Joint Infections in the Elderly

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Joya Singh ◽  
Suresh J. Antony
Keyword(s):  
Antibiotic Treatment ◽  
The Elderly ◽  
Oral Antibiotic ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Prosthetic joint infections in the elderly

Infection ◽  
2015 ◽  
Vol 43 (6) ◽  
pp. 629-637 ◽  
Author(s):  
G. De Angelis ◽  
N. T. Mutters ◽  
L. Minkley ◽  
F. Holderried ◽  
E. Tacconelli
Keyword(s):  
The Elderly ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

scholarly journals Prosthetic joint infection by Bordetella holmesii: Case report and a review of the literature

2020 ◽  
Vol 43 (11) ◽  
pp. 748-750
Author(s):  
Mariana Fernandez-Pittol ◽  
Jordi Bosch ◽  
Laura Morata ◽  
Luis Lozano ◽  
Juan Carlos Martínez Pastor ◽  
...  
Keyword(s):  
Case Report ◽  
Synovial Fluid ◽  
Antibiotic Treatment ◽  
Knee Prosthesis ◽  
Case Reports ◽  
Joint Effusion ◽  
Rrna Gene ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Introduction: Bordetella holmesii is a Gram-negative coccobacillus involved in different infections mostly described in case reports. Prosthetic joint infections in relation to this pathogen are rare. Here, we present the third case of B. holmesii in a patient without anatomical or functional spleen dysfunction. Case report: The patient was a 62-year-old female with a total knee prosthesis implanted in 1997 that required multiple replacements of the femoral component due to aseptic loosening in the past years. The patient was admitted to our hospital for an elective replacement surgery due to new radiological signs of loosening. B. holmesii was isolated from synovial fluid obtained during surgery. The identification was performed by matrix-assisted laser desorption ionization–time of flight mass spectrometry and confirmed by 16S rRNA gene amplification and sequencing. Antibiotic treatment was started but 14 days after surgery the patient presented pain and joint effusion. An arthrocentesis was performed and synovial fluid culture was positive again for B. holmesii. Surgical debridement including polyethylene replacement was performed and antibiotic treatment was continued for 3 months. After a 2-year follow-up period, the patient remained asymptomatic and physical examination showed normal function of the prosthesis. Conclusion: B. holmesii is an uncommon cause of bone and joint infections. This case indicates that this microorganism is a potential pathogen of prosthetic or native arthritis, and it should be considered when cultures are negative and in cases presenting torpid evolution.

scholarly journals Handling of Doubtful WBC Scintigraphies in Patients with Suspected Prosthetic Joint Infections

2020 ◽  
Vol 9 (12) ◽  
pp. 4031
Author(s):  
Chiara Lauri ◽  
Giancarlo Lauretti ◽  
Filippo Galli ◽  
Giuseppe Campagna ◽  
Simone Tetti ◽  
...  
Keyword(s):  
Visual Analysis ◽  
Joint Infection ◽  
White Blood Cells ◽  
Final Diagnosis ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Significant Difference ◽  
Sensitivity Specificity

Despite the application of EANM recommendations for radiolabelled white-blood-cells (WBC) scintigraphy, some cases still remain doubtful based only on visual analysis. The aim of this study was to investigate the role of semi-quantitative analysis and bone marrow scan (BMS) in solving doubtful cases. We retrospectively evaluated all [99mTc]HMPAO-WBC scintigraphies performed, in the last 7 years, for a suspected monolateral prosthetic joint infection (PJI). In doubtful cases, we used five different thresholds of increase of target-to-background (T/B) ratio, between delayed and late images, as criteria of positivity (5%, 10%, 15%, 20% and 30%). BMS were also analysed and sensitivity, specificity and accuracy of different methods were calculated according to final diagnosis. The sensitivity, specificity and accuracy were, respectively, 77.8%, 43.8% and 53.0% for the cut-off at 5%; 72.2%, 66.7% and 68.2% for the cut-off at 10%; 66.7%, 75.0% and 72.7% for the cut-off at 15%; 66.7%, 85.4% and 80.3% for the cut-off at 20%; 33.3%, 93.8% and 77.3% for the cut-off at 30%. BMS provided a significantly higher diagnostic performance than 5%, 10% and 15% thresholds. Conversely, we did not observe any statistically significant difference between BMS and the cut-off of more than 20%. Therefore, doubtful cases should be analysed semi-quantitatively. An increase in T/B ratio of more than 20% between delayed and late images, should be considered as a criterion of positivity, thus avoiding BMS.

scholarly journals Chronic prosthetic joint infections with a draining sinus. Who should receive suppressive antibiotic treatment?

2020 ◽  
Vol 6 (2) ◽  
pp. 43-45
Author(s):  
Karel-Jan Lensen ◽  
Rosa Escudero-Sanchez ◽  
Javier Cobo ◽  
Alex Soriano ◽  
Marjan Wouthuyzen-Bakker
Keyword(s):  
Antibiotic Treatment ◽  
Patient Group ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Sinus Tract ◽  
Advantages And Disadvantages ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Abstract. The benefit of suppressive antibiotic treatment in inoperable patients with a chronic periprosthetic joint infection and a sinus tract is unknown. Some physicians prefer to just let the sinus drain, while others prefer antibiotic treatment. In this viewpoint article we discuss the advantages and disadvantages of suppressive antibiotic treatment in this particular patient group.

scholarly journals Current Status of Molecular Imaging in Infections

2018 ◽  
Vol 24 (7) ◽  
pp. 754-771 ◽  
Author(s):  
Martina Sollini ◽  
Chiara Lauri ◽  
Roberto Boni ◽  
Elena Lazzeri ◽  
Paola Anna Erba ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Current Status ◽  
Non Invasive ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Pet Ct ◽  
Prosthetic Joint Infections ◽  
Flow Charts

There is an increased need to find non-invasive tools for early diagnosis and follow-up of infections. Nuclear medicine techniques may be used to diagnose, localize and evaluate the severity and the extent of infections before the occurrence of anatomical abnormalities. This review focuses on different approaches based on radiolabelled cells, peptides and antibodies or [18F]FDG to image infective diseases in agreement with what is being jointly evaluated by the European Association of Nuclear Medicine (EANM). This is particularly relevant, since the EANM has strated a wide program of collaboration with other European clinical societies to define common diagnostic flow-charts in many of these infective diseases. It emerges the role of radiolabelled WBC by SPECT/CT for prosthetic joint infections and of FDG by PET/CT for spondylodiscitis. Comparable values of accuracy have been described for WBC and FDG in the diagnosis of vascular fgraft infections, diabetic gfoot, endocarditis and peripheral bone osteomyelitis, with some exceptions.

scholarly journals Outcome of Acute Prosthetic Joint Infections Due to Gram-Negative Bacilli Treated with Open Debridement and Retention of the Prosthesis

2009 ◽  
Vol 53 (11) ◽  
pp. 4772-4777 ◽  
Author(s):  
Juan C. Martínez-Pastor ◽  
Ernesto Muñoz-Mahamud ◽  
Félix Vilchez ◽  
Sebastián García-Ramiro ◽  
Guillem Bori ◽  
...  
Keyword(s):  
Regression Model ◽  
Cox Regression ◽  
Oral Antibiotic ◽  
Cox Regression Model ◽  
Gram Negative ◽  
Joint Infections ◽  
Kaplan Meier ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Open Debridement

ABSTRACT The aim of our study was to evaluate the outcome of acute prosthetic joint infections (PJIs) due to gram-negative bacilli (GNB) treated without implant removal. Patients with an acute PJI due to GNB diagnosed from 2000 to 2007 were prospectively registered. Demographics, comorbidity, type of implant, microbiology data, surgical treatment, antimicrobial therapy, and outcome were recorded. Classification and regression tree analysis, the Kaplan-Meier survival method, and the Cox regression model were applied. Forty-seven patients were included. The mean age was 70.7 years, and there were 15 hip prostheses and 32 knee prostheses. The median number of days from the time of arthroplasty was 20. The most frequent pathogens were members of the Enterobacteriaceae family in 41 cases and Pseudomonas spp. in 20 cases. Among the Enterobacteriaceae, 14 were resistant to ciprofloxacin, while all Pseudomonas aeruginosa isolates were susceptible to ciprofloxacin. The median durations of intravenous and oral antibiotic treatment were 14 and 64 days, respectively. A total of 35 (74.5%) patients were in remission after a median follow-up of 463 days (interquartile range, 344 to 704) days. By use of the Kaplan-Meier survival curve, a C-reactive protein (CRP) concentration of ≤15 mg/dl (P = 0.03) and receipt of a fluoroquinolone, when all GNB isolated were susceptible (P = 0.0009), were associated with a better outcome. By use of a Cox regression model, a CRP concentration of ≤15 mg/dl (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.05 to 12.5; P = 0.043) and receipt of a fluoroquinolone (OR, 9.09; 95% CI, 1.96 to 50; P = 0.005) were independently associated with better outcomes. Open debridement without removal of the implant had a success rate of 74.5%, and the factors associated with good prognosis were a CRP concentration at the time of diagnosis ≤15 mg/dl and treatment with a fluoroquinolone.

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