Recent  

In a first evaluation, the accuracy of a novel multiplex PCR (polymerase chain reaction) panel for rapid detection of pathogens in patients with a clinical suspicion of acute septic arthritis of native and prosthetic joints is assessed. Clear benefit is seen in patients with a suspected native septic arthritis and late acute prosthetic joint infection. This indicates that the panel allows for fast tailoring of antibiotics and may prompt the surgeon for surgical lavage in doubtful clinical cases.

We present the first published case of bilateral extensor tenosynovitis caused by Coxiella burnetii. C. burnetii should be considered in patients with inflammatory osteoarticular disease, including tenosynovitis, when conventional cultures are negative especially in elderly, male, or immunocompromised patients with exposure to animals.

Management of septic arthritis in native joints (SANJO) is often conducted by clinicians of different specialties, experience levels, and at all hours of the day. The SANJO guideline group makes evidence-based recommendations for diagnosis, microbiological investigation, initial surgery, empirical antibiotic treatment, early mobilization, evaluation of outcomes, and treatment failure. Special considerations were made for children, tuberculosis, and SANJO after cruciate ligament reconstruction.

Currently, there is no method available to reload antibiotic carriers to treat late bone infections or to prevent bacterial attachment. We propose a novel method to load and protect a biphasic calcium sulfate/hydroxyapatite (CaS/HA) carrier material from bacterial re-population by systemically administering a clinical dose of HA-seeking antibiotic rifampicin (RIF). CaS/HA-based carriers could recruit HA-seeking RIF to locally exert an adequate antibacterial effect at the targeted tissue.

Tuberculosis is a serious public health problem. A retrospective study of a series of cases of patients with a diagnosis of osteoarticular tuberculosis was carried out from 2014 to 2019. A total of 30 patients were confirmed. The presence of sequelae was correlated with the presence of motor deficit at the beginning of treatment and the high value of C-reactive protein at the end of treatment. These results may contribute to a better understanding of this disease to reduce complications.

Pan-spine MRI is warranted in patients who require operative treatment for pyogenic spinal infection to evaluate for multifocal infection.

Our multicentre study on a lower-limb osteosynthesis-associated infection (OAI) cohort by multidrug (MDR) and extensively drug (XDR) resistant Gram-negative bacteria found the following: implant retention with debridement was mostly performed in early OAI; 50.9 % of patients achieved remission of infection; remission reached 50 % (MDR) vs. 25 % (XDR) in early OAI and 60 % (MDR) vs. 44.4 % (XDR) in late OAI; age (> 60) and multiple surgeries were independent factors influencing lack of remission.

The scientific publication score (SPS) summarizes specific publication results. It is organized into five levels (1–5) based on evidence, data and statistical criteria. In risk factors for prosthetic joint infections, the highest scores were noted for anemia, malignancy and previous alloarthroplasty; for diagnosis methods, these were obtained for aspirate leucocyte count, neutrophils over 80 and interleukin-6 level. SPS is a promising new tool for automatic data mining and systematic reviews.

This systematic review presents the results regarding the concordance rate between preoperative synovial fluid and intraoperative tissue culturing in patients with a prosthetic joint infection (PJI). The included studies had heterogeneous results and were at a high risk of bias. Higher-quality future research may help to better understand the true concordance between these cultures. This may result in better guidance for orthopedic surgeons regarding the treatment of patients with PJI.

Despite a growing interest in oral therapy for native vertebral osteomyelitis, there is no evidence to recommend oral or parenteral therapy. From our single-center experience combined with a systematic review and a meta-analysis of the available literature, there is insufficient evidence to conclude that there is a difference in proportion of failure and relapse between an early switch to oral antibiotics and prolonged parenteral therapy. Further studies are needed to increase the evidence.

A Madura foot caused by the fungus Madurella mycetomatis is a rare condition in non-endemic countries, but should be included in the differential diagnosis in case of soft tissue swellings of the foot in patients who have been in mycetomatis-endemic regions, more specifically in immunocompromised patients, who are at risk of developing a (more severe) mycetoma infection. Adequate treatment is needed to prevent the progression and recurrence of a Madura foot.

Every year the incidence of prosthetic joint infection (PJI) continues to increase. Therefore, it required a way to reduce complications, one of them coating methods. However, the best preventive strategy is still debatable. Through various review processes, it was finally discovered that coating methods using antibiotics were an effective method to prevent the occurrence of PJI, while coating with non-antibiotic materials such as silver and iodine is significant in preventing incidence of PJI.

Treatments for prosthetic joint infections (PJIs) are often assessed using a success or failure endpoint. Yet, this can fail to capture important outcomes for patients. A desirability of outcome ranking (DOOR) is a way of evaluating treatments in a more patient-focused form. This study found an outcome ranking using joint function, infection cure and quality of life. This helps to answer what are we trying to achieve for patients with PJI and how we measure the effectiveness of PJI treatments.