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.

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.

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.

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.

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.

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.

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.

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.