Clin Microbiol Infect 2011; 17: 439-444 ABSTRACT: Experience with debridement and prosthesis retention in early prosthetic joint infections (PJI) due to Staphylococcus aureus is scarce. The present study aimed to evaluate the outcome and predictors of failure. Patients prospectively registered with an early PJI due to S. aureus and 2 years of ...

Bacillus species infection of the joints is a very rare occurrence, with sporadic reports in the medical literature. A 67-year-old woman with osteoarthritis developed infection in the knee joint after arthroscopy. Percutaneous needle aspiration of articular fluid performed post-operatively showed a positive culture for Bacillus species. The diagnosis of septic ...

The optimum treatment for prosthetic joint infections has not been clearly defined. We report our experience of the management of acute haematogenous prosthetic joint infection (AHPJI) in patients during a 3-year prospective study in nine Spanish hospitals. Fifty patients, of whom 30 (60%) were female, with a median age of ...

Septic arthritis of a lumbar facet joint is a rare condition. We report the case of a 77-year-old diabetic woman who developed fever and back pain 15 days after she had been diagnosed with a genitourinary infection for which she had received ciprofloxacin. Physical examination showed fever (38°C) and pain ...

Twelve group B Streptococcus (GBS) prosthetic joint infection (PJI) cases are reported. The mean patient age was 55 years. Eleven infections were caused by GBS alone. The associated isolates belonged to phylogenetic lineages different from those that cause neonatal meningitis. The clinical outcome was favorable for the eight patients for ...

Synovial fluid samples from culture-confirmed infected joints (n=13), joints with pronounced non-infectious synovitis (n=11) and healthy joints (n=14) were collected from 24 equine patients and seven slaughterhouse horses. The samples from the joints with non-infectious synovitis and healthy joints served as negative controls. After isolation, counting and identification of neutrophils, ...

A host of technical and operative improvements have seen the rates of infection associated with joint replacement reach historic lows. However, the increasing number of operations being performed means that the absolute number of such infections remains significant. Diagnosis may be challenging and delaying appropriate treatment can lead to reduced ...

Clin Microbiol Infect 2011; 17: 862-867 ABSTRACT: Information is required about treatment outcomes of Gram-negative prosthetic joint infections treated with prosthesis retention and surgical debridement, especially where biofilm-active antibiotics such as fluoroquinolones are used. The outcome of 17 consecutive patients with an early Gram-negative prosthetic joint infection who had been ...

Over the past years there has been a significant increase in the number of joint prosthesis replacements worldwide. The most serious complication of joint prosthesis is infection with an incidence of 1.5-2.5% for primary interventions and up to 20% for revision procedures. The mortality rate ranges between 1% and nearly ...

BACKGROUND: Joint replacement surgery has been on the increase in recent decades and prosthesis infection remains the most critical complication. Many aspects of the primary prevention and clinical management of such prosthesis infections still need to be clarified. CONTROVERSIAL ISSUES: The aim of this GISIG (Gruppo Italiano di Studio sulle ...

Patients with specific temporomandibular joint (TMJ) conditions and pathology may benefit from TMJ reconstruction by use of total joint prostheses. A potential risk to patients receiving TMJ total joint prostheses is infection. The purpose of this study was to present our experience in treating infected TMJ total joint prostheses over ...

Aspergillosis is an important cause of morbidity and mortality in birds. Turkey poults are known to be particularly susceptible to fungal infection. Although the respiratory tract is the most commonly affected, dissemination can occur into virtually any organ. Here, we report an unusual outbreak of articular aspergillosis in a flock ...

Periprosthetic joint infection has become the most common cause of failure following total knee arthroplasty. Over the past 4 decades, treatment of this disease has evolved with technological innovations and pathogen profiling. The appropriate treatment selection is dependent on patient immune system quality, timing of symptom onset, and pathogen type. ...

BACKGROUND: The preoperative diagnosis of prosthetic joint infection in patients with a total hip or knee arthroplasty may rely in part on the use of systemic inflammation markers. These markers have unclear accuracy. The objective of this review was to summarize the evidence on the accuracy of the peripheral white ...

Chronic tophaceous gout is a disabling erosive arthritis characterized by an elevated serum urate concentration, recurrent attacks of arthritis, and deposits of monosodium urate crystals in synovial fluids. Tophi, ulcerations of the overlying skin, and fissures of the interarticular cartilage may occur in advanced stages, combined with deformities of the ...

Invasive group B streptococcus (GBS) is an increasing cause of infection in orthopaedic patients. Risk factors include increasing age, diabetes mellitus and immune deficiency. It may cause native and periprosthetic joint sepsis, cellulitis, fasciitis, soft tissue abscesses and osteomyelitis. We describe the epidemiology and outcome from GBS infection in a ...

BACKGROUND/PURPOSE: Pediatric acute osteoarticular infections remain a challenging clinical issue for physicians. This paper provides recent clinical experiences on acute community-acquired osteoarticular infections in children in Taiwan. METHODS: Children with acute community-acquired osteoarticular infections admitted to hospital were retrospectively reviewed and the findings compared with related infections in Taiwan published ...

Infections of the sternoclavicular joint associated with extensive local soft tissue involvement or abscess formation often require surgical debridement and drainage. This condition typically presents with joint pain, local erythema, and swelling. This case demonstrates the simultaneous extension of a sternoclavicular joint infection into the left upper pulmonary lobe and ...

Late hematogenous infection of previously asymptomatic orthopedic implants is extremely rare and usually associated with total joint replacements, such as those of the hip or knee. We present the case of an otherwise healthy female who developed a deep space infection 18 months after a first metatarsophalangeal joint implant arthroplasty. ...

The role of bacterial infections in the pathogenesis of rheumatoid arthritis (RA) has gained increasing interest. Patients with RA often exhibit periodontal disease, which is associated with pathogens like Porphyromonas gingivalis. The present study examines the direct effects of P. gingivalis on apoptosis of human chondrocytes (a feature of inflammatory ...

The orthopedic community has begun to witness a worrisome rise in the incidence of periprosthetic joint infections (PJIs) caused by resistant organisms. Besides other challenges associated with treating these infections, it appears that these infections may pose a higher cost compared to infections caused by sensitive organisms. Significantly higher cost ...

The aim of this study was to describe the prevalence and characteristics of knee prosthetic joint infections due to extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. From 2000 to 2007, 132 infections out of 5,076 arthroplasties (2.6%) were registered. Seven out of 132 infections (5.3%) were due to ESBL-producing Enterobacteriaceae, Escherichia coli in ...

OBJECTIVE: Prosthetic joint infection should be treated for a prolonged time (3 months for hip, 6 months for knee infection). Most authors require normalization of CRP before stopping antimicrobial therapy. However, in some patients the CRP values remain slightly elevated despite adequate treatment. METHOD: We observed 14 patients with prosthetic ...

When dealing with prosthetic joint infections (PJI) there is often the need to start antibiotic therapy without having identified the underlying pathogen. Under these circumstances there is no consensus regarding which antibiotic to use. We aimed to produce local recommendations for empirical antibiotic treatment of PJI by describing the microbiological ...

Numerous protocols are used to treat an infected total joint arthroplasty. We evaluated survival outcomes of patients with infected total joint arthroplasties over 35 years to determine if one treatment is more effective than others.Of 17,561 total joint arthroplasties performed at our facility, 116 (0.66%) were diagnosed with deep infection, ...

The factors associated with prosthetic joint infection for 126 patients in a case-control study were as follows: bacteremia during the previous year (odds ratio [OR], 4.25 [95% confidence interval {CI}, 1.3-3.8]), nonsurgical trauma to the prosthetic joint (OR, 21.5 [95% CI, 2.6-175.2]), and surgical site infection (OR, 5.25 [95% CI, ...

The objective of the study was to determine if a clonal complex (CC) of Staphylococcus aureus or certain virulence and adhesion factors were associated with infections of bones and prosthetic implants. One hundred and nineteen isolates were characterised using microarrays. There was no evidence for a single virulence factor or ...

Successful treatment of an infected joint arthroplasty depends on correctly identifying the responsible pathogens. The value of a preoperative biopsy remains controversial. We (1) compared the sensitivity and specificity of both tests separately and in combination, and (2) asked whether the combination of tissue biopsy and aspiration would improve our ...

Prosthetic joint replacement is increasingly used to alleviate pain and increase mobility. Bone and joint infections remain a therapeutic dilemma for healthcare providers in all fields. Antimicrobial agents combined with appropriate surgical techniques play a vital role in eradicating infections associated with prosthetic joints. The question still remains whether monotherapy ...

Facet joint septic arthritis is a rare but severe infection with the possibility of significant morbidity resulting from local or systemic spread of the infection. Pain is the most common complaint on presentation followed by fever, then neurologic impairment. While the lumbar spine is involved in the vast majority of ...

Post-arthroplasty infections represent a devastating complication of total joint replacement surgery, resulting in multiple reoperations, prolonged antibiotic use, extended disability and worse clinical outcomes. As the number of arthroplasties in the U.S. will exceed 3.8 million surgeries per year by 2030, the number of post-arthroplasty infections is projected to increase ...

Infection around the shoulder joint is rare. Clinical suspicion and diagnostic imaging are required for accurate diagnosis. We present three cases that emphasise particular diagnostic challenges when dealing with infection around the shoulder joint. Discussion includes the role of ultrasound as a screening tool and the importance of magnetic resonance ...

Periprosthetic joint infection is now the leading cause of failure after a total knee arthroplasty, and Staphylococcus aureus, most commonly from the patient's own flora, typically is the infective agent. Several preoperative screening tests have been developed to identify patients who are carrying methicillin-resistant S aureus. Testing and decolonization programs ...

The diagnosis of prosthetic joint infection and its differentiation from aseptic loosening remains problematic. The definitive laboratory diagnostic test is the recovery of identical infectious agents from multiple intraoperative tissue samples; however, interpretation of positive cultures is often complex as infection is frequently associated with low numbers of commensal microorganisms, ...

The increasing numbers of joint arthroplasties being undertaken, and the increase in patients with systemic illnesses undergoing the procedure, have contributed to a continuing increase in prosthetic joint infections. Candida prosthetic joint infection is a rare clinical entity, and only 12 cases of Candida albicans prosthetic hip infection have been ...

The objective of this study was to assess natural microbial agents, history and risk factors for total joint arthroplasty (TJA) infections in patients receiving tumor necrosis factor (TNF)α-blockers, through the French RATIO registry and a case-control study. Cases were TJA infections during TNFα-blocker treatments. Each case was compared to two ...

Abstract The optimum treatment for prosthetic joint infections has not been clearly defined. In this study, our experience in the management of acute hematogenous prosthetic joint infection (AHPJI) is presented by analyzing data from patients with AHPJI prospectively identified during a 3-year period in 9 Spanish hospitals. Fifty patients, 30 ...

Infection of the sternoclavicular joint (SJI) is a rare problem accounting for approximately 1 % of cases of septic arthritis. Patients typically present with symptoms of localized pain lasting a period of several weeks with or without systemic signs of fever and chills. Confirmation is made by aspirating the joint, ...

BACKGROUND AND AIMS: An epidemiological analysis of cases of spontaneous community acquired septic arthritis in an elderly population at a university teaching hospital. METHODS: Confirmed cases of spontaneous septic arthritis in the over-65 population were studied. Patients with prosthetic joint infections were excluded from the study. Analysed data included initial ...

Bone and joint infections are recognized as difficult-to-treat infections that result in significant morbidity and mortality among patients and increased healthcare costs. This article presents the recommendations for the diagnosis and management of osteomyelitis and prosthetic joint infections in adults developed by Bone and Joint Infections Committee for the Italian ...

In this study, we describe 13 patients with prosthetic infections due to Finegoldia magna (2% of our tested series). Patients presented with either polymicrobial infection after an open fracture or nosocomial infection after recent prosthesis implantation. Molecular techniques are critical for diagnosis, and recommended antibiotic prophylaxis has poor activity against ...

BACKGROUND: Septic arthritis of the shoulder is a rare infection in healthy children. This infection requires prompt surgical drainage and antibiotic treatment. A delay in surgical intervention can result in damage to the articular surface of the glenohumeral joint, adjacent osteomyelitis, and possible growth disturbance. The clinical course of septic ...

While diagnosing infection of a joint prosthesis often requires a multi-modal approach, evaluation of combined multiple diagnostics is still a rather subjective process. Based on the known sensitivity and specificity of commonly performed tests for joint prosthesis infection, we developed the Combined Diagnostic Tool, a software program that automatically allows ...

OBJECTIVES: To identify factors associated with complicated Staphylococcus aureus bacteremia (SAB) in adults. METHODS: Prospective observational multicenter study during 2 years in Nice University Hospital and during 6 months in the H??pital Europ??en Georges Pompidou, Paris, including all adult inpatients with SAB assessed by an Infectious Diseases (ID) specialist. RESULTS: ...

This report describes the first reported case of a prosthetic hip joint infection due to Campylobacter coli. The infection presumably resulted from ingestion of contaminated raw oysters. Issues regarding original smear interpretation, culture isolation, and susceptibility testing are presented.

On 10 October 2007, a Black Vulture (Coragyps atratus) was presented to the Wildlife Center of Virginia, Waynesboro, Virginia, USA, because of an inability to fly. Examination revealed multiple swollen, fluctuant joints. The bird suffered from lead toxicosis and had a prominent leukocytosis. Histopathologic evaluation revealed an acute fibrinoheterophilic polyarthritis, ...

In addition to the examination of clinical signs, several laboratory markers have been measured for diagnostics and monitoring of pediatric septic bone and joint infections. Traditionally erythrocyte sedimentation rate (ESR) and leukocyte cell count have been used, whereas C-reactive protein (CRP) has gained in popularity. We monitored 265 children at ...

OBJECTIVE: To describe the epidemiological, clinical, and laboratory characteristics of patients with group B streptococcal (GBS) prosthetic joint infections, their diagnoses, treatment, and long-term outcomes. METHODS: We conducted a retrospective cohort study including all patients hospitalized from January 1994 through May 2006 for a GBS prosthetic joint infection. RESULTS: The ...

Periprosthetic joint infection is one of the most challenging complications of total joint arthroplasty. We evaluated the incidence of early-onset (less than 2 years) and late-onset (greater than 2 years) periprosthetic joint infection after primary total hip arthroplasty (THA). The Medicare 5% national sample data set (1997-2006) was used to ...

A rare case of a severe prosthetic joint infection in a 71-year-old immunocompetent woman is presented. Listeria monocytogenes was identified in two consecutive samples using broad-range PCR and sequencing, whereas cultivation remained negative for the first sample and streptococci of a non-group A streptococci, non-group B streptococci type were detected ...