Articles | Volume 6, issue 8
https://doi.org/10.5194/jbji-6-363-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-6-363-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Viewpoint: Periprosthetic joint infection and dental antibiotic prophylaxis guidelines
Department of Dental Specialties,
Division of Periodontics, Mayo Clinic, Rochester, MN, USA
Elie F. Berbari
Department of Medicine, Division of Infectious
Diseases, Mayo Clinic, Rochester, MN, USA
Cory G. Couch
Department of Medicine, Division of Orthopedics,
Mayo Clinic, Rochester, MN, USA
Scott F. Gruwell
Department of Dental Specialties,
Division of Periodontics, Mayo Clinic, Rochester, MN, USA
Alan B. Carr
Department of Dental
Specialties, Division of Prosthodontics, Mayo Clinic, Rochester, MN, USA
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Seyed Mohammad Amin Alavi, Fabio Borgonovo, Francesco Petri, Takahiro Matsuo, Andrea Gori, Jeremy D. Shaw, Aaron J. Tande, and Elie F. Berbari
J. Bone Joint Infect., 10, 451–457, https://doi.org/10.5194/jbji-10-451-2025, https://doi.org/10.5194/jbji-10-451-2025, 2025
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The rising rate of spinal surgeries has led to more postoperative infections, yet no standardized diagnostic criteria exist. We analyzed over 100 studies and found considerable variation in definitions. Our findings underscore the need for a unified diagnostic framework that integrates clinical signs, laboratory data, and imaging to enhance diagnostic accuracy, support clinical decision-making, and improve consistency in future research.
Fabio Borgonovo, Francesco Petri, Takahiro Matsuo, Rita Igwilo-Alaneme, Seyed Mohammad Amin Alavi, Omar K. Mahmoud, Said El Zein, Matteo Passerini, Mohammad Hassan Murad, Daniel C. DeSimone, Ahmad Nassr, Aaron J. Tande, Andrea Gori, and Elie F. Berbari
J. Bone Joint Infect., 10, 425–435, https://doi.org/10.5194/jbji-10-425-2025, https://doi.org/10.5194/jbji-10-425-2025, 2025
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We studied a serious double infection affecting the heart and spine, often seen in older or immunocompromised patients. By analyzing systematic data from the literature, we found that this condition leads to high death rates, especially when caused by the bacterium Staphylococcus aureus. Our work highlights the urgent need for higher-quality studies and better coordinated care. These findings may help guide future treatment strategies and improve outcomes for affected patients.
Francesco Petri, Omar Mahmoud, Said El Zein, Ahmad Nassr, Brett A. Freedman, Jared T. Verdoorn, Aaron J. Tande, and Elie F. Berbari
J. Bone Joint Infect., 9, 173–182, https://doi.org/10.5194/jbji-9-173-2024, https://doi.org/10.5194/jbji-9-173-2024, 2024
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In recent years, there has been an increase in scientific production on native vertebral osteomyelitis (NVO), a condition whose incidence is rising and that can be highly detrimental to health. However, there is no consensus on the definition of this syndrome in the medical community. Therefore, we propose a new framework to synthesize the diagnostic tools at our disposal. This can help to advance research further and guide patient care more effectively.
Said El Zein, Elie F. Berbari, Allison M. LeMahieu, Anil Jagtiani, Parham Sendi, Abinash Virk, Mark E. Morrey, and Aaron J. Tande
J. Bone Joint Infect., 9, 107–115, https://doi.org/10.5194/jbji-9-107-2024, https://doi.org/10.5194/jbji-9-107-2024, 2024
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Our study investigated olecranon septic bursitis treatment, focusing on postsurgical antibiotic use. Analyzing 22 years of Mayo Clinic data, we found that smoking and not administering antibiotics following surgery led to poorer outcomes. A 3-week antibiotic course following surgery was most effective. Our findings suggest that a subset of patients may benefit from longer courses of antibiotics; however, further research is needed to confirm these findings.
Matteo Passerini, Julian Maamari, Don Bambino Geno Tai, Robin Patel, Aaron J. Tande, Zelalem Temesgen, and Elie F. Berbari
J. Bone Joint Infect., 8, 143–149, https://doi.org/10.5194/jbji-8-143-2023, https://doi.org/10.5194/jbji-8-143-2023, 2023
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Physicians have difficulties interpreting the isolation of Cutibacterium acnes in the spine tissue. Here we provide the experience of our center about this topic, adding data that can help physicians in their choices. Our results show that some clinical, radiological, and microbiological features can help distinguish patients to treat or not to treat. Moreover, treatment with parenteral beta-lactams appears to be effective, but targeted oral therapy could be a valid alternative.
Eibhlin Higgins, Don Bambino Geno Tai, Brian Lahr, Gina A. Suh, Elie F. Berbari, Kevin I. Perry, Matthew P. Abdel, and Aaron J. Tande
J. Bone Joint Infect., 8, 125–131, https://doi.org/10.5194/jbji-8-125-2023, https://doi.org/10.5194/jbji-8-125-2023, 2023
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This retrospective case-matched study evaluated males and females with staphylococcal PJI (periprosthetic joint infection) treated with two-stage exchange arthroplasty. We matched 156 males and females for age, type of staphylococcal infection, and joint involved. We compared clinical parameters related to presentation, treatment, and outcome. We did not find a statistically significant difference in outcome between males and females treated with the same surgical approach at our institution.
Matteo Passerini, Julian Maamari, Tarek Nayfeh, Leslie C. Hassett, Aaron J. Tande, Mohammad H. Murad, Zelalem Temesgen, and Elie F. Berbari
J. Bone Joint Infect., 7, 249–257, https://doi.org/10.5194/jbji-7-249-2022, https://doi.org/10.5194/jbji-7-249-2022, 2022
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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.
Talha Riaz, Matthew Howard, Felix Diehn, Aaron Joseph Tande, Courtney Ross, Paul Huddleston, and Elie Berbari
J. Bone Joint Infect., 7, 213–219, https://doi.org/10.5194/jbji-7-213-2022, https://doi.org/10.5194/jbji-7-213-2022, 2022
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In this study, we prospectively enrolled patients with a suspected diagnosis of native vertebral osteomyelitis (NVO) undergoing image-guided needle aspiration of the intervertebral disc. Based on this pilot study, a high manual cell count or a high neutrophilic predominance from the disc aspirate was associated with the diagnosis of NVO.
Julian Maamari, Aaron J. Tande, Felix Diehn, Don Bambino Geno Tai, and Elie F. Berbari
J. Bone Joint Infect., 7, 23–32, https://doi.org/10.5194/jbji-7-23-2022, https://doi.org/10.5194/jbji-7-23-2022, 2022
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The yearly incidence of native vertebral osteomyelitis (NVO) is increasing. In 2013 the prevalence of NVO in the USA was 5.4 cases per 100 000. Delays in the diagnosis of NVO remain common, in part due to the insidious nature of the infection and its related symptoms. The mean time between the onset of symptoms to diagnosis of NVO is 45.5 d. We herein review available and novel diagnostic modalities at the disposal of healthcare providers to reach an accurate and timely diagnosis of NVO.
Cited articles
Ainscow, D. A. and Denham, R. A.: The risk of haematogenous infection in
total joint replacements, J. Bone Joint Surg. Br., 66, 580–582, 1984.
Berbari, E. F., Osmon, D. R., Carr, A., Hanssen, A. D., Baddour, L. M.,
Greene, D., Kupp, L. I., Baughan, L. W., Harmsen, W. S., Mandrekar, J. N.,
Therneau, T. M., Steckelberg, J. M., Virk, A., and Wilson, W. R.: Dental
procedures as risk factors for prosthetic hip or knee infection: a
hospital-based prospective case-control study, Clin. Infect. Dis., 50, 8–16,
https://doi.org/10.1086/648676, 2010.
Cruess, R. L., Bickel, W. S., and von Kessler, K. L.: Infections in total
hips secondary to a primary source elsewhere, Clin. Orthop. Relat. Res., 99–101,
https://doi.org/10.1097/00003086-197501000-00013, 1975.
Fogelberg, E. V., Zitzmann, E. K., and Stinchfield, F. E.: Prophylactic
penicillin in orthopaedic surgery, J. Bone Joint Surg. Am., 52, 95–98, 1970.
Goff, D. A., Mangino, J. E., Glassman, A. H., Goff, D., Larsen, P., and
Scheetz, R.: Review of Guidelines for Dental Antibiotic Prophylaxis for
Prevention of Endocarditis and Prosthetic Joint Infections and Need for
Dental Stewardship, Clin. Infect. Dis., 71, 455–462, https://doi.org/10.1093/cid/ciz1118, 2020.
Jacobson, J. J. and Matthews, L. S.: Bacteria isolated from late prosthetic
joint infections: dental treatment and chemoprophylaxis, Oral Surg. Oral Med.
Oral Pathol., 63, 122–126, https://doi.org/10.1016/0030-4220(87)90352-5, 1987.
Maderazo, E. G., Judson, S., and Pasternak, H.: Late infections of total
joint prostheses. A review and recommendations for prevention, Clin. Orthop.
Relat. Res., 229, 131–142, 1988.
Quinn, R. H., Murray, J. N., Pezold, R., Sevarino, K. S., Members of the,
W., and Members of the Writing
Voting Panels of the A. U. C. for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures: The
American Academy of Orthopaedic Surgeons Appropriate Use Criteria for the
Management of Patients with Orthopaedic Implants Undergoing Dental
Procedures, J. Bone Joint Surg. Am., 99, 161–163, https://doi.org/10.2106/JBJS.16.01107, 2017.
Rethman, M. P.,
Watters 3rd, W.,
Abt, E.,
Anderson, P. A.,
Carroll, K. C.,
Evans, R. P.,
Futrell, H. C.,
Garvin, K.,
Glenn, S. O.,
Goldberg, M. J.,
Hellstein, J.,
Hewlett, A.,
Kolessar, D.,
Moucha, C.,
O' Donnell, R. J.,
Osmon, D. R.,
O' Toole J.,
Rinella, A.,
Steinberg, M. J.,
Martin 3rd, W. R.,
Cummins, D. S.,
Song, S.,
Sluka, P.,
Boyer, K.,
Woznica, A.,
Ristic, H.,
Hanson, N. B.,
American Academy of Orthopaedic, S., and American Dental, A.: The American
Academy of Orthopaedic Surgeons and the American Dental Association clinical
practice guideline on the prevention of orthopaedic implant infection in
patients undergoing dental procedures, J. Bone Joint Surg. Am., 95, 745–747,
https://doi.org/10.2106/00004623-201304170-00011, 2013.
Slullitel, P. A., Oñativia, J. I., Piuzzi, N. S., Higuera-Rueda, C., Parvizi, J., and Buttaro, M. A.: Is there a Role for Antibiotic Prophylaxis Prior to Dental Procedures in Patients with Total Joint Arthroplasty? A Systematic Review of the Literature, J. Bone Joint Infect., 5, 7–15, https://doi.org/10.7150/jbji.40096, 2020.
Waldman, B. J., Mont, M. A., and Hungerford, D. S.: Total knee arthroplasty
infections associated with dental procedures, Clin. Orthop. Relat. Res., 343,
164–172, 1997.
Short summary
This was written to outline Mayo Clinic guidelines on prophylactic antibiotics prior to invasive procedures in patients with prosthetic joints. There is an emphasis on maintaining optimal oral health to reduce the risk of infection to minimize the patient’s risk of PJI.
This was written to outline Mayo Clinic guidelines on prophylactic antibiotics prior to invasive...