Articles | Volume 9, issue 4
https://doi.org/10.5194/jbji-9-191-2024
© Author(s) 2024. 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-9-191-2024
© Author(s) 2024. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Emergence of rifampicin-resistant staphylococci on the skin and nose of rifampicin-treated patients with an orthopaedic-device-related infection
Alexandra Wallimann
AO Research Institute Davos, Davos, Switzerland
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Yvonne Achermann
Department of Internal Medicine, Hospital Zollikerberg, Zollikerberg, Switzerland
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
Department of Infectious Diseases and Hospital Epidemiology, University of Zurich, Zurich, Switzerland
Ciara Ferris
AO Research Institute Davos, Davos, Switzerland
Mario Morgenstern
Center for Musculoskeletal Infections (ZMSI), University Hospital Basel, Basel, Switzerland
Department of Orthopedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland
Martin Clauss
Center for Musculoskeletal Infections (ZMSI), University Hospital Basel, Basel, Switzerland
Department of Orthopedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland
Vincent Stadelmann
Department of Research and Development, Schulthess Klinik, Zurich, Switzerland
Hannes Andreas Rüdiger
Department of Hip and Knee Surgery, Schulthess Klinik, Zurich, Switzerland
Liam O'Mahony
Departments of Medicine and Microbiology, APC Microbiome Ireland, University College Cork, College Road, Cork, Ireland
Thomas Fintan Moriarty
CORRESPONDING AUTHOR
AO Research Institute Davos, Davos, Switzerland
Center for Musculoskeletal Infections (ZMSI), University Hospital Basel, Basel, Switzerland
Related authors
No articles found.
Marta Sabater-Martos, Martin Clauss, Ana Ribau, Ricardo Sousa, and on behalf of the Leukocyte Count Synovial Fluid working group for the Unified PJI definition task force
J. Bone Joint Infect., 10, 165–184, https://doi.org/10.5194/jbji-10-165-2025, https://doi.org/10.5194/jbji-10-165-2025, 2025
Short summary
Short summary
This meta-analysis evaluates synovial fluid white blood cell count and polymorphonuclear neutrophil proportion in order to diagnose chronic peri-prosthetic joint infection. Based on 74 studies, it identifies optimal thresholds, with rule-in and rule-out thresholds enhancing diagnostic precision. Confounding factors such as fractures and inflammatory arthritis are addressed. The findings support standardized diagnostic frameworks in improving accuracy and clinical consistency.
Irene K. Sigmund, Marjan Wouthuyzen-Bakker, Tristan Ferry, Willem-Jan Metsemakers, Martin Clauss, Alex Soriano, Rihard Trebse, and Ricardo Sousa
J. Bone Joint Infect., 10, 139–142, https://doi.org/10.5194/jbji-10-139-2025, https://doi.org/10.5194/jbji-10-139-2025, 2025
Short summary
Short summary
This is a summary of our position paper on debridement, antimicrobial therapy, and implant retention (DAIR) procedures as a curative treatment strategy for acute periprosthetic hip and knee infections. It includes the defined indications as well as the contraindications of DAIR procedures when eradication/cure is intended, based on the currently available literature.
Irene K. Sigmund, Tristan Ferry, Ricardo Sousa, Alex Soriano, Willem-Jan Metsemakers, Martin Clauss, Rihard Trebse, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 10, 101–138, https://doi.org/10.5194/jbji-10-101-2025, https://doi.org/10.5194/jbji-10-101-2025, 2025
Short summary
Short summary
In this paper, we discuss the most relevant factors influencing the outcome and define indications, contraindications, and risk factors of a DAIR procedure based on the currently available literature. Furthermore, we discuss the surgical technique in combination with systemic antimicrobial therapy in patients undergoing a DAIR procedure.
Baixing Chen, T. Fintan Moriarty, Hans Steenackers, Georges F. Vles, Jolien Onsea, Thijs Vackier, Isabel Spriet, Rob Lavigne, R. Geoff Richards, and Willem-Jan Metsemakers
J. Bone Joint Infect., 9, 249–260, https://doi.org/10.5194/jbji-9-249-2024, https://doi.org/10.5194/jbji-9-249-2024, 2024
Short summary
Short summary
Our research explores natural antimicrobials to combat orthopedic-device-related infections, a challenging issue due to antibiotic resistance. We reviewed agents from bacteria, fungi, viruses, animals, plants and minerals, evaluating their effectiveness and synergy with traditional antibiotics. Our findings suggest these natural alternatives could revolutionize infection management in orthopedic patients, offering new hope for reducing antibiotic resistance and improving treatment outcomes.
Noémie Reinert, Katinka Wetzel, Fabian Franzeck, Mario Morgenstern, Markus Aschwanden, Thomas Wolff, Martin Clauss, and Parham Sendi
J. Bone Joint Infect., 9, 183–190, https://doi.org/10.5194/jbji-9-183-2024, https://doi.org/10.5194/jbji-9-183-2024, 2024
Short summary
Short summary
We assessed concordance of in-house guidelines for diagnostic principles and antibiotic treatment duration (ABT) 2 years after their implementation. The goal was to standardize diagnostic and treatment principles: are we doing what we recommend? The adherence to recommendations in terms of biopsy sampling was good, moderate for histopathology and poor for anatomic labeling. In terms of ABT duration, the adherence was good, but further shortening for surgically cured cases is necessary.
Stéphanie Pascual, Brooklyn Noble, Nusreen Ahmad-Saeed, Catherine Aldridge, Simone Ambretti, Sharon Amit, Rachel Annett, Shaan Ashk O'Shea, Anna Maria Barbui, Gavin Barlow, Lucinda Barrett, Mario Berth, Alessandro Bondi, Nicola Boran, Sara E. Boyd, Catarina Chaves, Martin Clauss, Peter Davies, Ileana T. Dianzo-Delgado, Jaime Esteban, Stefan Fuchs, Lennart Friis-Hansen, Daniel Goldenberger, Andrej Kraševac Glaser, Juha O. Groonroos, Ines Hoffmann, Tomer Hoffmann, Harriet Hughes, Marina Ivanova, Peter Jezek, Gwennan Jones, Zeynep Ceren Karahan, Cornelia Lass-Flörl, Frédéric Laurent, Laura Leach, Matilde Lee Horsbøll Pedersen, Caroline Loiez, Maureen Lynch, Robert J. Maloney, Martin Marsh, Olivia Milburn, Shanine Mitchell, Luke S. P. Moore, Lynn Moffat, Marianna Murdjeva, Michael E. Murphy, Deepa Nayar, Giacomo Nigrisoli, Fionnuala O'Sullivan, Büşra Öz, Teresa Peach, Christina Petridou, Mojgan Prinz, Mitja Rak, Niamh Reidy, Gian Maria Rossolini, Anne-Laure Roux, Patricia Ruiz-Garbajosa, Kordo Saeed, Llanos Salar-Vidal, Carlos Salas Venero, Mathyruban Selvaratnam, Eric Senneville, Peter Starzengruber, Ben Talbot, Vanessa Taylor, Rihard Trebše, Deborah Wearmouth, Birgit Willinger, Marjan Wouthuyzen-Bakker, Brianne Couturier, and Florence Allantaz
J. Bone Joint Infect., 9, 87–97, https://doi.org/10.5194/jbji-9-87-2024, https://doi.org/10.5194/jbji-9-87-2024, 2024
Short summary
Short summary
This study conducted in multiple sites across Europe aimed to evaluate the BIOFIRE Joint Infection (JI) Panel, a new technology that uses multiplex PCR to detect microorganisms in synovial fluid of patients with suspicion of joint infections in 1 h, in comparison with synovial fluid culture. Results showed an overall agreement of 85 % to 88.4 % between the two methods. The JI Panel detected additional organisms, and the positive user experience highlights its clinical significance.
Simon Martin Heinrich, Parham Sendi, and Martin Clauss
J. Bone Joint Infect., 6, 423–424, https://doi.org/10.5194/jbji-6-423-2021, https://doi.org/10.5194/jbji-6-423-2021, 2021
Short summary
Short summary
We report on an 83-year-old woman who had an open removal of a baker's cyst several months after total knee arthroplasty. The following wound healing problem was first misinterpreted as being superficial. With an injection of methylene blue and a contrast medium, we showed the extent of the sinus tract, proving the periprosthetic joint infection.
Cited articles
Achermann, Y., Eigenmann, K., Ledergerber, B., Derksen, L., Rafeiner, P., Clauss, M., Nüesch, R., Zellweger, C., Vogt, M., and Zimmerli, W.: Factors associated with rifampin resistance in staphylococcal periprosthetic joint Infections (PJI): A matched case–control study, Infection, 41, 431–437, https://doi.org/10.1007/s15010-012-0325-7, 2013.
Goldstein, B. P.: Resistance to Rifampicin: A Review, J. Antibiot., 67, 625–630, https://doi.org/10.1038/ja.2014.107, 2014.
Hellmark, B., Unemo, M., Nilsdotter-Augustinsson, Å., and Söderquist, B.: Antibiotic Susceptibility among Staphylococcus Epidermidis Isolated from Prosthetic Joint Infections with Special Focus on Rifampicin and Variability of the RpoB Gene, Clin. Microbiol. Infec., 15, 238–244, https://doi.org/10.1111/j.1469-0691.2008.02663.x, 2009.
Ju, O., Woolley, M., and Gordon, D.: Emergence and Spread of Rifampicin-Resistant, Methicillin-Resistant Staphylococcus Aureus during Vancomycin–Rifampicin Combination Therapy in an Intensive Care Unit, Eur. J. Clin. Microbiol. Infect. Dis., 25, 61–62, https://doi.org/10.1007/s10096-005-0063-1, 2006.
Lai, C. C., Che-Kim, T., Sheng-Hsiang, L., Chun-Hsing, L., Yu-Tsung, H., and Po-Ren, H.: Emergence of rifampicin resistance during rifampicin-containing treatment in elderly patients with persistent methicillin-resistant staphylococcus aureus bacteremia, J. Am. Geriatr. Soc., 58, 1001–1003, https://doi.org/10.1111/j.1532-5415.2010.02842.x, 2010.
Masters, E. A., Ricciardi, B. F., de Mesy Bentley, K. L., Moriarty, T. F., Schwarz, E. M., and Muthukrishnan, G.: Skeletal Infections: Microbial Pathogenesis, Immunity and Clinical Management, Nat. Rev. Microbiol., 20, 385–400, https://doi.org/10.1038/s41579-022-00686-0, 2022.
Mick, V., Domínguez, M. L., Tubau, F., Liñares, J., Pujol, M., and Martín, R.: Molecular Characterization of Resistance to Rifampicin in an Emerging Hospital-Associated Methicillin-Resistant Staphylococcus Aureus Clone ST228, Spain, BMC Microbiol., 10, 68, https://doi.org/10.1186/1471-2180-10-68, 2010.
Padayachee, T. and Klugman, K. P.: Molecular Basis of Rifampin Resistance in Streptococcus Pneumoniae, Antimicrob. Agents Ch., 43, 2361–2365, https://doi.org/10.1128/AAC.43.10.2361, 1999.
Wi, Y. M., Greenwood-Quaintance, K. E., Brinkman, C. L., Lee, J. Y. H., Benjamin, P., Howden, B. P., and Patel, R.: Rifampicin Resistance in Staphylococcus Epidermidis: Molecular Characterisation and Fitness Cost of RpoB Mutations, Int. J. Antimicrob. Agents, 51, 670–677, https://doi.org/10.1016/j.ijantimicag.2017.12.019, 2018.
Zimmerli, W. and Sendi, P.: Role of Rifampin against Staphylococcal Biofilm Infections In Vitro, in Animal Models, and in Orthopedic-Device-Related Infections, Antimicrob. Agents Chemother., 63, e01746-18, https://doi.org/10.1128/AAC.01746-18, 2019.
Zimmerli, W., Widmer, A. F., Blatter, M., Frei, R., and Ochsner, P. E.: Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. Foreign-Body Infection (FBI) Study Group, JAMA, 279, 1537, https://doi.org/10.1001/jama.279.19.1537, 1998.
Short summary
Skin commensal bacteria such as staphylococci are often the source of orthopaedic-device-related infections. Rifampicin is a widely used antibiotic in the treatment of these infections. The results of this study show that oral rifampicin therapy leads to a consistent and persistent induction of resistance in commensal staphylococci on the skin and in the nose for a prolonged time.
Skin commensal bacteria such as staphylococci are often the source of orthopaedic-device-related...