Articles | Volume 9, issue 1
https://doi.org/10.5194/jbji-9-37-2024
© 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-9-37-2024
© Author(s) 2024. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Optimized decision algorithm for the microbiological diagnosis of osteoarticular infections in adults using synovial fluid samples: a prospective study in two French hospitals including 423 samples of synovial fluid
Céline Dupieux
CORRESPONDING AUTHOR
Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France
Ghislaine Descours
Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France
Paul Verhoeven
Laboratoire de Bactériologie, CHU de Saint-Étienne, Saint-Étienne, 42055, France
Florence Grattard
Laboratoire de Bactériologie, CHU de Saint-Étienne, Saint-Étienne, 42055, France
Yvonne Benito
Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France
François Vandenesch
Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France
Céline Cazorla
Service de Maladies Infectieuses, CHU de Saint-Étienne, Saint-Étienne, 42055, France
Tristan Ferry
Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France
Sébastien Lustig
Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France
Bertrand Boyer
Service de Chirurgie Orthopédique, CHU de Saint-Étienne, Saint-Étienne, 42055, France
Sandrine Boisset
Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France
Anne Carricajo
Laboratoire de Bactériologie, CHU de Saint-Étienne, Saint-Étienne, 42055, France
Frédéric Laurent
Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France
A full list of authors appears at the end of the paper.
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J. Bone Joint Infect., 10, 489–500, https://doi.org/10.5194/jbji-10-489-2025, https://doi.org/10.5194/jbji-10-489-2025, 2025
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Isolation of patients with musculoskeletal infections in orthopedic care is controversial. Evidence supports selective isolation for certain resistant pathogens but not for non-resistant pathogens, nor does it support the routine use of septic wards. Effective infection control depends on hospital-wide strategies and adherence to standard precautions, with specialized centres offering better care than dedicated isolation units.
Irene K. Sigmund, Marjan Wouthuyzen-Bakker, Tristan Ferry, Willem-Jan Metsemakers, Martin Clauss, Alex Soriano, Rihard Trebse, and Ricardo Sousa
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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.
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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.
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
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Parham Sendi and Tristan Ferry
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J. Bone Joint Infect., 7, 127–136, https://doi.org/10.5194/jbji-7-127-2022, https://doi.org/10.5194/jbji-7-127-2022, 2022
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We describe 48 osteocutaneous-flap-related osteomyelitis cases, mostly presenting with early, local signs of infection and/or bone exposure. Main pathogens were Gram-negative bacilli, streptococci, S. aureus, enterococci, and anaerobes, justifying a broad-spectrum empirical antimicrobial therapy. Despite surgery and a 3-month antimicrobial therapy, a 50 % failure rate was recorded, associated with a delayed infectious disease specialist referral and advocating for multidisciplinary management.
Truong-Thanh Pham, Eugénie Mabrut, Philippe Cochard, Paul Chardon, Hassan Serrier, Florent Valour, Laure Huot, Michel Tod, Gilles Leboucher, Christian Chidiac, and Tristan Ferry
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Costs related to off-label expensive antibiotics used to treat bone and joint infections (BJIs) in a referral centre in France were analysed in this cohort study. Despite the large increase in the number of patients treated with these antibiotics, the overall costs remained stable (approximately EUR 1 million) and were helped by the appearance of generic molecules at lower prices. Production of generic antibiotics at low cost is essential to limit the financial burden of the management of BJIs.
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Short summary
We define an algorithm to optimize bone and joint infection diagnosis in adults on synovial fluid samples. This prospective multi-center study included a large number of synovial fluids and compared the performance of classical culture on different media, inoculation of synovial fluid in blood culture bottles, and broad-range and specific PCR. We proposed an algorithm associating culture onto three solid media and into blood culture bottles and 16S, Staphylococcus, and Streptococcus PCR.
We define an algorithm to optimize bone and joint infection diagnosis in adults on synovial...