1,721,126 research outputs found
Periprosthetic joint infections: a practical overview for family physicians
L’infection de prothèse articulaire est une complication rare mais redoutée. Sa prise en charge nécessite une collaboration entre médecin de premier recours, orthopédiste et infectiologue. Une méconnaissance du diagnostic peut avoir pour conséquences des traitements chirurgicaux lourds. L’identification du germe responsable de l’infection est essentielle. Elle guide le choix de l’antibiothérapie et est aussi un critère décisif de la stratégie chirurgicale. Une antibiothérapie ne devrait jamais être instaurée sans prélèvement microbiologique adéquat préalable. Ici, le frottis de plaie superficielle n’est d’aucune utilité, car il reflète tout au plus la colonisation par des germes de la flore cutanée. Cette revue se veut un aperçu pratique des infections de prothèse articulaire à l’attention du médecin de premier recours.Periprosthetic joint infection is a rare but serious complication. Its management requires the collaboration between general practitioner, orthopaedic surgeon and infectious disease specialist. A delay in the diagnosis can result in complications, requiring complex surgical procedures. Identification of the causative pathogen and its susceptibility pattern is crucial, because it guides both the choice of antimicrobial treatment and the surgical strategy. Antimicrobial treatment without proper micro- biological sampling must be avoided. Swabs from open wounds are not helpful, because microorganisms belonging to the skin flora will grow. The target audience of this review article on periprosthetic joint infections is the general practitioner
Diagnosis of periprosthetic joint infections in clinical practice
The diagnosis of a periprosthetic joint infection (PJI) can be challenging, either because of the variable clinical presentation or because of previous antimicrobial treatment interfering with the detection of the pathogen. In recent years, various means to diagnose PJI have been analyzed. These include invasive and non-invasive laboratory tests, imaging procedures, and novel techniques such as sonication of implants and the use of molecular microbiology. In this review, both established and novel diagnostic procedures are presented. An algorithm for detecting PJI in patients with acute and chronic symptoms is proposed
Infective endocarditis caused by Streptococcus agalactiae: time for beta-hemolytic streptococci to follow treatment recommendations for S. aureus?
Precision Medicine in the Diagnosis and Management of Orthopedic Biofilm Infections
Orthopedic biofilm infections are difficult to treat and require a multidisciplinary approach to diagnostics and management. Recent advances in the field include methods to disrupt biofilm, sequencing tools, and antibiotic susceptibility tests for bacteria residing in biofilm. The observation of interclonal differences in biofilm properties of the causative microorganisms, together with considerations of comorbidities and polypharmacy in a growing aging population, calls for a personalized approach to treat these infections. In this article, we highlight aspects of precision medicine that may open new perspectives in the diagnosis and management of orthopedic biofilm infections
Role of Rifampin against Staphylococcal Biofilm Infections , in Animal Models, and in Orthopedic-Device-Related Infections.
Rifampin has been used as an agent in combination therapy in orthopedic device-related infections (ODRI) for almost three decades. The aim of this review is to provide data regarding the role of rifampin against biofilm infection , in animal models, and in clinical ODRI. Available data are gathered in order to present the rational use of rifampin combinations in patients with periprosthetic joint infection (PJI). The role of rifampin is well defined in patients with PJI and is indicated in those who fulfill the Infectious Diseases Society of America criteria for debridement and implant retention or one-stage exchange. It should be used with care because of the danger of rapid emergence of resistance. Potential drug interactions should be considered
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