Disseminated Mycobacterium abscessus infection is a rare clinical presentation that is challenging to treat due to the limited number of therapeutic options available. This complex case involved multi-speciality input across two hospitals. In the absence of guidelines for the management of extra-pulmonary and disseminated disease, our case  highlights which pharmacological agents were used and how surgery was utilised to achieve source control.

Septic arthritis is a dangerous joint infection that requires rapid treatment. We analysed patient data to test common blood and synovial fluid markers and a newly developed composite score combining these markers. The score demonstrated higher sensitivity than individual tests alone within this dataset. Prospective validation in larger cohorts is required before clinical application.

The aim of this proof-of-concept study was to investigate host immune gene expression through transcriptome profiling in patients with fracture-related infection and to explore the feasibility of detecting 16S rRNA and biofilm-associated genes, an approach not previously applied using this method. This technique revealed distinct immune activation patterns in fracture-related infection (FRI) and enabled the identification of pathogens that were missed by conventional culture techniques. 

Timely and accurate pathogen identification is essential for managing periprosthetic joint infections (PJIs), yet conventional culturing often yields false negatives and requires prolonged incubation. We evaluated an in-vivo-like synovial fluid medium and isothermal microcalorimetry. The combined use of these approaches improved detection rates and reduced time to diagnosis, offering valuable insights to advance PJI diagnostics and support better clinical decision-making.

This retrospective study analyzed 682 patients who underwent primary total hip or knee arthroplasty to evaluate the impact of malnutrition on post-operative outcomes. Malnutrition, as defined by the Nutritional Risk Screening 2002 (NRS-2002) and controlling nutritional status (CONUT) scores, was significantly associated with higher rates of post-operative infection and poorer quality-of-life scores. Early nutritional assessment may improve post-operative recovery and reduce complication rates.

This study examined thousands of joint fluid samples to understand which bacteria cause infections in natural and artificial joints. Staphylococci were the main culprits, and antibiotic resistance increased over time, especially in methicillin-resistant and beta-lactamase-producing strains. Testing joint fluids in blood culture bottles improved detection, helping doctors to choose more effective treatments and protect joint health.

Founded in 2019, the Center for Musculoskeletal Infections at University Hospital Basel was established to implement standardized, multidisciplinary care for orthopaedic and trauma-related infections. This retrospective analysis of hip and knee periprosthetic joint infections (2019–2022) illustrates the feasibility and effectiveness of this structured approach, with infection control achieved in the majority of patients despite case complexity.

Periprosthetic joint infection (PJI) patient care has both positive and negative impacts on caregivers: (1) conflicts regarding the hospital stay, (2) novel personal challenges, (3) nursing, (4) emotional and psychological consequences, and (5) effects on the relationship. To conclude, caregivers of PJI patients shoulder a relevant burden both physically and emotionally, which seems to be very similar to caregivers of cancer patients. An inclusion in established treatment algorithms for PJI should be considered.

Although local antibiotic administration is used to prevent and treat fracture-related infections, concerns remain about systemic absorption and potential renal toxicity. This study assessed serum levels and renal function after local gentamicin or vancomycin use. Gentamicin exceeded the lower limit of quantification in 17% of cases but remained below toxic levels. Vancomycin was undetectable. These findings suggest that local antibiotic administration does not harm renal function.

Pseudomonas aeruginosa is a common pathogen in Gram-negative periprosthetic joint infections (PJIs). It is resistant to many antibiotics and forms biofilm, making it difficult to treat. We analyzed 1286 patients who underwent 1640 surgeries; among them, 38 patients with 50 procedures had P. aeruginosa. Most infections were chronic, often in hip revisions, with a high failure rate and recurrence. Due to its clinical and microbiological features, P. aeruginosa-related PJIs remain challenging.

In Lyme-endemic regions, Lyme disease should be considered in culture-negative periprosthetic joint infection (PJI). Diagnosis relies on microbial DNA detection, particularly Borrelia-targeted polymerase chain reaction (PCR) on synovial fluid or tissue. We present 10 cases highlighting the value of PCR for early recognition of this pathogen, which is not detectable by conventional culture media. Surgical debridement remains the standard of care, though several cases were successfully treated medically, an observation that merits further investigation.

In this study, we tested whether very high doses and prolonged exposure of gentamicin, alone or with rifampin, can eliminate mature Staphylococcus aureus biofilm – one of the main causes of implant-associated infections. None of the regimes tested eradicated all bacteria. Adding rifampin gave no benefit. This suggests that aminoglycosides are not optimal for local antibiotic therapy.

This study assessed whether the diagnosis and management of fracture-related infections (FRIs) in a low- and middle-income countries (LMICs) currently align with consensus guidelines. We found that two-thirds of cases are managed outside the international guidelines. While the consensus definition is applicable, diagnostic capacity remains limited and microbiological standards are often impractical. Our findings highlight the need to adapt guidelines to local realities and to strengthen capacity in LMICs.

Several factors have been linked to failure in chronic prosthetic joint infection revisions. We hypothesize that osteomyelitis in septic hip revisions is underestimated and may significantly impact outcomes. In this series, 30.8 % of septic revisions exhibited bone samples consistent with osteitis, mainly associated with prolonged unsuccessful surgical and antibiotic treatments, the presence of a sinus tract, and subsequent failure after implant removal.

Fungal organisms are conventionally estimated to account for 1 % –2 % of periprosthetic joint infection (PJI) cases, although diagnostic and reporting limitations may result in systematic underestimation. Using a quantitative missing-data sensitivity analysis across 23 studies encompassing 28 253 PJI cases, we estimated an adjusted Candida PJI proportion of approximately 5 %, increasing to nearly 10 % in chronic or refractory infections.

Infections represent a serious complication following the implantation of osteoarticular devices. Rifampicin in combination with fluoroquinolone is the most prescribed antibiotic regimen. Nevertheless, fluoroquinolones are associated with significant adverse effects. We sought to evaluate whether oral tetracyclines could serve as an alternative therapeutic option. Our findings suggest that tetracyclines may constitute a suitable alternative in cases where fluoroquinolones are not usable.

A simple, rapid, and low-cost test measuring synovial fluid specific gravity shows high accuracy and excellent specificity for diagnosing hip and knee periprosthetic joint infection. This method can quickly help rule in infections during revision surgeries, making it a practical point-of-care tool, especially in clinics or hospitals with limited resources. Its performance supports use alongside established lab markers for better patient outcomes.

Staphylococcus aureus bloodstream infection can cause serious complications such as bone and joint involvement. We reviewed 489 cases (2017–2022) at a Brussels tertiary hospital to identify risk factors. Prolonged bacteremia and community acquisition increased the risk, while active cancer and intensive-care stay reduced it. This study highlights the burden of bone and joint infections in Staphylococcus aureus bloodstream infection.

This is a case report which follows a patient who received multiple false positive synovial alpha-defensin test results following a revision for total knee arthroplasty. The report looks at the importance of generalizability in diagnostic testing and how a lack thereof can extend the cost and duration of care.