Articles | Volume 9, issue 1
https://doi.org/10.5194/jbji-9-87-2024
© 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-9-87-2024
© Author(s) 2024. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Original full-length article
| 
28 Feb 2024
Original full-length article |
| 28 Feb 2024
| 28 Feb 2024
Potential value of a rapid syndromic multiplex PCR for the diagnosis of native and prosthetic joint infections: a real-world evidence study
Stéphanie Pascual
CORRESPONDING AUTHOR
bioMérieux, Marcy l'Etoile, France
Brooklyn Noble
bioMérieux, Salt Lake City, USA
Nusreen Ahmad-Saeed
University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Catherine Aldridge
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
Simone Ambretti
S. Orsola Bologna, Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Sharon Amit
Sheba Medical Center, Ramat Gan, Israel
Rachel Annett
University Hospital of Wales, Cardiff, Wales, United Kingdom
Shaan Ashk O'Shea
University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Anna Maria Barbui
San Giovanni Battista, Department of Public Health and Pediatrics Microbiology and Virology Unit, Città della Salute e della Scienza, Turin, Italy
Gavin Barlow
Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
Lucinda Barrett
Oxford University Hospitals (OUH), Oxford, United Kingdom
Mario Berth
AZ Alma, Eeklo, Belgium
Alessandro Bondi
Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Nicola Boran
Mater Misericordiae University Hospital, Dublin, Ireland
Sara E. Boyd
Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
Catarina Chaves
Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Martin Clauss
University Hospital Basel, Basel, Switzerland
Peter Davies
NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, University of Glasgow, Glasgow, United Kingdom
Ileana T. Dianzo-Delgado
Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
Jaime Esteban
Dept. of Clinical Microbiology, IIS-Fundación Jiménez Díaz, CIBERINFEC-CIBER de Enfermedades Infecciosas, Madrid, Spain
Stefan Fuchs
Institute of Hygiene and Medical Microbiology Medizinische Universität Innsbruck, Innsbruck, Austria
Lennart Friis-Hansen
Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark
Dept. Clinical Microbiology at Rigshospitalet, Copenhagen, Denmark
Daniel Goldenberger
University Hospital Basel, Basel, Switzerland
Andrej Kraševac Glaser
NZOLH Maribor, Maribor, Slovenia
Juha O. Groonroos
Varsinais-Suomen sairaanhoitopiiri, Loimaa, Finland
Ines Hoffmann
MVZ Labor Dr. Reising-Ackermann und Kollegen, Limbach Leipzig, Germany
Tomer Hoffmann
Sheba Medical Center, Ramat Gan, Israel
Harriet Hughes
University Hospital of Wales, Cardiff, Wales, United Kingdom
Marina Ivanova
East Tallinn Central Hospital, Tallin, Estonia
Peter Jezek
Regional Hospital Příbram, Příbram, Czech Republic
Gwennan Jones
University Hospital of Wales, Cardiff, Wales, United Kingdom
Zeynep Ceren Karahan
Ankara University School of Medicine Department of Medical Microbiology, Ankara, Türkiye
Cornelia Lass-Flörl
Institute of Hygiene and Medical Microbiology Medizinische Universität Innsbruck, Innsbruck, Austria
Frédéric Laurent
Hospices Civils de Lyon, Lyon, France
Laura Leach
Oxford University Hospitals (OUH), Oxford, United Kingdom
Matilde Lee Horsbøll Pedersen
Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark
Dept. Clinical Microbiology at Rigshospitalet, Copenhagen, Denmark
Caroline Loiez
Centre Hospitalier Universitaire de Lille, Lille, France
Maureen Lynch
Mater Misericordiae University Hospital, Dublin, Ireland
Robert J. Maloney
Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
Martin Marsh
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
Olivia Milburn
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
Shanine Mitchell
University Hospital of Wales, Cardiff, Wales, United Kingdom
Luke S. P. Moore
Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
Lynn Moffat
NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, University of Glasgow, Glasgow, United Kingdom
Marianna Murdjeva
University Hospital “St George”, Plovdiv, Bulgaria
Michael E. Murphy
NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, University of Glasgow, Glasgow, United Kingdom
Deepa Nayar
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
Giacomo Nigrisoli
S. Orsola Bologna, Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Fionnuala O'Sullivan
Mater Misericordiae University Hospital, Dublin, Ireland
Büşra Öz
Ankara University School of Medicine Department of Medical Microbiology, Ankara, Türkiye
Teresa Peach
University Hospital of Wales, Cardiff, Wales, United Kingdom
Christina Petridou
Hampshire Hospitals NHS Foundation Trust, Winchester, UK
Mojgan Prinz
Krankenhaus Göttlicher Heiland, Vienna, Austria
Mitja Rak
Koper lab, Orthopedic Hospital Valdoltra, Valdoltra, Slovenia
Niamh Reidy
Mater Misericordiae University Hospital, Dublin, Ireland
Gian Maria Rossolini
Careggi University Hospital, Florence, Italy
Anne-Laure Roux
Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France
Patricia Ruiz-Garbajosa
CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III. Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
Kordo Saeed
University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Llanos Salar-Vidal
Dept. of Clinical Microbiology, IIS-Fundación Jiménez Díaz, CIBERINFEC-CIBER de Enfermedades Infecciosas, Madrid, Spain
Carlos Salas Venero
Hospital Universitario Marqués de Valdecilla, Santander, Spain
Mathyruban Selvaratnam
Oxford University Hospitals (OUH), Oxford, United Kingdom
Eric Senneville
Centre Hospitalier Universitaire de Lille, Lille, France
Peter Starzengruber
Allgemeines Krankenhaus Wien, Vienna, Austria
Ben Talbot
NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, University of Glasgow, Glasgow, United Kingdom
Vanessa Taylor
University Hospital of Wales, Cardiff, Wales, United Kingdom
Rihard Trebše
Koper lab, Orthopedic Hospital Valdoltra, Valdoltra, Slovenia
Deborah Wearmouth
Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
Birgit Willinger
Allgemeines Krankenhaus Wien, Vienna, Austria
Marjan Wouthuyzen-Bakker
University Medical Center Groningen, Groningen, the Netherlands
Brianne Couturier
bioMérieux, Salt Lake City, USA
Florence Allantaz
bioMérieux, Marcy l'Etoile, France
Editorial note: the article was erroneously published with the co-author Andrej Golle from NZOLH Maribor, Slovenia. In fact, the respective co-author was meant to be Andrej Kraševac Glaser, also affiliated with NZOLH Maribor. This was corrected on 29 May 2024.
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Irene K. Sigmund, Marjan Wouthuyzen-Bakker, Tristan Ferry, Willem J. 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
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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.
Irene K. Sigmund, Tristan Ferry, Ricardo Sousa, Alex Soriano, Willem J. 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
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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.
Tariq Azamgarhi, Simon Warren, Antonia Scobie, Natasha Karunaharan, Cristina Perez-Sanchez, Rebecca Houghton, Salma Hassan, Julie Lourtet-Hascoët, Hannah Kershaw, Parham Sendi, and Kordo Saeed
J. Bone Joint Infect., 10, 93–100, https://doi.org/10.5194/jbji-10-93-2025, https://doi.org/10.5194/jbji-10-93-2025, 2025
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This study evaluates dalbavancin, an antibiotic with a long duration of action, in treating complex bone and joint infections. It does not require daily dosing, allowing patients to leave the hospital earlier and reducing costs. Dalbavancin is shown to be effective and safe, especially for patients unsuitable for oral antibiotics or outpatient therapy, achieving similar results to traditional treatments while cutting healthcare costs.
Charlotte Smith, Robert J. Maloney, Deborah Wearmouth, Hemant Sharma, Kordo Saeed, Nusreen Ahmad-Saeed, Rachel Annett, Lucinda Barrett, Sara E. Boyd, Peter Davies, Harriet Hughes, Gwennan Jones, Laura Leach, Maureen Lynch, Deepa Nayar, Martin Marsh, Shanine Mitchell, Lynn Moffat, Luke S. P. Moore, Michael E. Murphy, Shaan Ashk O'Shea, Teresa Peach, Christina Petridou, Niamh Reidy, Ben Talbot, Catherine Aldridge, and Gavin Barlow
J. Bone Joint Infect., 10, 61–71, https://doi.org/10.5194/jbji-10-61-2025, https://doi.org/10.5194/jbji-10-61-2025, 2025
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Urgent analysis of joint fluid is a common test in patients with possible septic arthritis (bacterial infection of a joint). One aspect of this test, called the Gram stain, is considered important clinically, but previous single hospital studies have suggested it will miss a considerable number of infections. This large multi-hospital UK study assessed this test and found that it will miss 73 % of infections, questioning its value. More research on rapid tests using new technologies is required.
Sebastian Simon, Marjan Wouthuyzen-Bakker, Susana Gardete Hartmann, Jennyfer A. Mitterer, Sujeesh Sebastian, Stephanie Huber, Bernhard J. H. Frank, and Jochen G. Hofstaetter
J. Bone Joint Infect., 10, 51–59, https://doi.org/10.5194/jbji-10-51-2025, https://doi.org/10.5194/jbji-10-51-2025, 2025
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We compared the re-revision rates in rTHA and rTKA (revison total hip and knee arthroplasty) with and without AB (antibiotic) treatment in patients with UPICs (unexpected positive intraoperative cultures). The re-revision rate between the AB group and the non-AB group was similar. Postoperative AB treatment did not result in a decreased re-revision rate in patients with UPICs in presumed aseptic rTHA and rTKA. Patients with pathogens classified as a likely contaminant can be safely ignored.
Seung-Jae Yoon, Paul C. Jutte, Alex Soriano, Ricardo Sousa, Wierd P. Zijlstra, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 9, 231–239, https://doi.org/10.5194/jbji-9-231-2024, https://doi.org/10.5194/jbji-9-231-2024, 2024
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This study validated three models for predicting infection after hip and knee replacement surgery. By analyzing data from 2684 patients in the Netherlands, Portugal, and Spain, we found that the models developed by Tan, Del Toro, and Bülow effectively identified high-risk patients. These models can be used to enhance preoperative counseling and to tailor infection prevention measures individually, potentially improving outcomes and reducing healthcare costs.
Alexandra Wallimann, Yvonne Achermann, Ciara Ferris, Mario Morgenstern, Martin Clauss, Vincent Stadelmann, Hannes Andreas Rüdiger, Liam O'Mahony, and Thomas Fintan Moriarty
J. Bone Joint Infect., 9, 191–196, https://doi.org/10.5194/jbji-9-191-2024, https://doi.org/10.5194/jbji-9-191-2024, 2024
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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.
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
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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.
Céline Dupieux, Ghislaine Descours, Paul Verhoeven, Florence Grattard, Yvonne Benito, François Vandenesch, Céline Cazorla, Tristan Ferry, Sébastien Lustig, Bertrand Boyer, Sandrine Boisset, Anne Carricajo, Frédéric Laurent, and PIRLA investigator group
J. Bone Joint Infect., 9, 37–48, https://doi.org/10.5194/jbji-9-37-2024, https://doi.org/10.5194/jbji-9-37-2024, 2024
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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.
Jorrit Willem Adriaan Schoenmakers, Rosanne de Boer, Lilli Gard, Greetje Anna Kampinga, Marleen van Oosten, Jan Maarten van Dijl, Paulus Christiaan Jutte, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 8, 45–50, https://doi.org/10.5194/jbji-8-45-2023, https://doi.org/10.5194/jbji-8-45-2023, 2023
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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.
Marjan Wouthuyzen-Bakker and Alexander L. Boerboom
J. Bone Joint Infect., 7, 33–34, https://doi.org/10.5194/jbji-7-33-2022, https://doi.org/10.5194/jbji-7-33-2022, 2022
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This case illustrates the clinical picture of a worn-out elbow prosthesis resulting in severe metallosis and a subsequent periprosthetic joint infection.
Karsten D. Ottink, Stefan J. Gelderman, Marjan Wouthuyzen-Bakker, Joris J. W. Ploegmakers, Andor W. J. M. Glaudemans, and Paul C. Jutte
J. Bone Joint Infect., 7, 1–9, https://doi.org/10.5194/jbji-7-1-2022, https://doi.org/10.5194/jbji-7-1-2022, 2022
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A low-grade periprosthetic joint infection (PJI) may be difficult to diagnose, and nuclear imaging could help in the diagnosis. However, its diagnostic value is unclear. We retrospectively evaluated this diagnostic value. We conclude that in patients presenting with nonspecific symptoms and a low a priori chance of PJI based on clinical evaluation, nuclear imaging is of no clear added value in diagnosing a PJI.
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
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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.
Karel-Jan Dag François Lensen, Rosa Escudero-Sanchez, Javier Cobo, Rihard Trebše, Camelia Gubavu, Sara Tedeschi, Jose M. Lomas, Cedric Arvieux, Dolors Rodriguez-Pardo, Massimo Fantoni, Maria Jose Garcia Pais, Francisco Jover, Mauro José Costa Salles, Ignacio Sancho, Marta Fernandez Sampedro, Alex Soriano, Marjan Wouthuyzen-Bakker, and ESCMID Study Group of Implant Associated Infections (ESGIAI)
J. Bone Joint Infect., 6, 313–319, https://doi.org/10.5194/jbji-6-313-2021, https://doi.org/10.5194/jbji-6-313-2021, 2021
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Our data suggest that, in periprosthetic joint infection (PJI) patients with a draining sinus, suppressive antibiotic treatment (SAT) can be considered on an individual basis. SAT may reduce pain and favour the closure of the sinus tract in certain individuals, but the prescription of SAT does not appear to have any influence on the prevention of prosthetic loosening and other infectious complications.
Karel-Jan Lensen, Rosa Escudero-Sanchez, Javier Cobo, Alex Soriano, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 6, 43–45, https://doi.org/10.5194/jbji-6-43-2020, https://doi.org/10.5194/jbji-6-43-2020, 2020
Related subject area
Subject: Microbiology of bone and joint infections | Topic: All topics
Multi-centre evaluation of Gram stain in the diagnosis of septic arthritis
Yield of routine mycobacterial culture of osteoarticular specimens in a tertiary orthopaedic hospital in England, 2017–2022
Musculoskeletal infections associated with Nocardia species: a case series
Musculoskeletal manifestations of lower-extremity coccidioidomycosis: a case series
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
Osteosynthesis-associated infection of the lower limbs by multidrug-resistant and extensively drug-resistant Gram-negative bacteria: a multicentre cohort study
Prosthetic joint infections caused by Mycobacterium avium complex: a series of five cases
Diagnosis of orthopaedic-implant-associated infections caused by slow-growing Gram-positive anaerobic bacteria – a clinical perspective
Charlotte Smith, Robert J. Maloney, Deborah Wearmouth, Hemant Sharma, Kordo Saeed, Nusreen Ahmad-Saeed, Rachel Annett, Lucinda Barrett, Sara E. Boyd, Peter Davies, Harriet Hughes, Gwennan Jones, Laura Leach, Maureen Lynch, Deepa Nayar, Martin Marsh, Shanine Mitchell, Lynn Moffat, Luke S. P. Moore, Michael E. Murphy, Shaan Ashk O'Shea, Teresa Peach, Christina Petridou, Niamh Reidy, Ben Talbot, Catherine Aldridge, and Gavin Barlow
J. Bone Joint Infect., 10, 61–71, https://doi.org/10.5194/jbji-10-61-2025, https://doi.org/10.5194/jbji-10-61-2025, 2025
Short summary
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Urgent analysis of joint fluid is a common test in patients with possible septic arthritis (bacterial infection of a joint). One aspect of this test, called the Gram stain, is considered important clinically, but previous single hospital studies have suggested it will miss a considerable number of infections. This large multi-hospital UK study assessed this test and found that it will miss 73 % of infections, questioning its value. More research on rapid tests using new technologies is required.
Tom A. Yates, Olivier Vahesan, Simon Warren, and Antonia Scobie
J. Bone Joint Infect., 9, 217–223, https://doi.org/10.5194/jbji-9-217-2024, https://doi.org/10.5194/jbji-9-217-2024, 2024
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Our orthopaedic hospital attempts to culture tuberculosis (TB) bacteria from all bone and joint samples sent to the microbiology laboratory. We looked at 6162 TB cultures performed between 2017 and 2022. Bacteria that cause TB, or similar bacteria, were found in 1 in every 229 patients. Tests were more likely to be positive in people being investigated for cancer (sarcoma) and in samples from the spine, whereas they were much less likely to be positive in samples taken from replacement joints.
Ryan B. Khodadadi, Jack W. McHugh, Supavit Chesdachai, Nancy L. Wengenack, Wendelyn Bosch, Maria Teresa Seville, Douglas R. Osmon, Elena Beam, and Zachary A. Yetmar
J. Bone Joint Infect., 9, 207–212, https://doi.org/10.5194/jbji-9-207-2024, https://doi.org/10.5194/jbji-9-207-2024, 2024
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In a multicenter retrospective study of musculoskeletal Nocardia infections (2011–2022), nine cases were identified. Disseminated disease occurred in 33 %, all in solid organ transplant recipients. Surgical intervention was common (89 %), with varied treatment duration (21–467 d). The 1-year mortality was 22%; all fatal cases involved disseminated disease. Localized infection generally had favorable outcomes compared to disseminated disease and requires a collaborative approach for management.
William Estes, L. Daniel Latt, Jacob Robishaw-Denton, Matthew L. Repp, Yash Suri, Tyson Chadaz, Christina Boulton, and Talha Riaz
J. Bone Joint Infect., 9, 197–205, https://doi.org/10.5194/jbji-9-197-2024, https://doi.org/10.5194/jbji-9-197-2024, 2024
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Musculoskeletal coccidioidomycosis can present in a variety of ways and often mimics non-infectious disease processes, making timely diagnosis challenging. Missed diagnosis can lead to devastating consequences, including joint destruction. Treatment often involves surgical debridement and prolonged antifungal therapy. Physicians in endemic areas should have a low threshold for obtaining Coccidioides-specific labs when patients present with unexplained musculoskeletal complaints.
Céline Dupieux, Ghislaine Descours, Paul Verhoeven, Florence Grattard, Yvonne Benito, François Vandenesch, Céline Cazorla, Tristan Ferry, Sébastien Lustig, Bertrand Boyer, Sandrine Boisset, Anne Carricajo, Frédéric Laurent, and PIRLA investigator group
J. Bone Joint Infect., 9, 37–48, https://doi.org/10.5194/jbji-9-37-2024, https://doi.org/10.5194/jbji-9-37-2024, 2024
Short summary
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.
Efthymia Giannitsioti, Mauro José Salles, Andreas Mavrogenis, Dolors Rodriguez-Pardo, Ibai Los-Arcos, Alba Ribera, Javier Ariza, María Dolores del Toro, Sophie Nguyen, Eric Senneville, Eric Bonnet, Monica Chan, Maria Bruna Pasticci, Sabine Petersdorf, Natividad Benito, Nuala O' Connell, Antonio Blanco García, Gábor Skaliczki, Pierre Tattevin, Zeliha Kocak Tufan, Nikolaos Pantazis, Panayiotis D. Megaloikonomos, Panayiotis Papagelopoulos, Alejandro Soriano, Antonios Papadopoulos, and the ESGIAI collaborators study group
J. Bone Joint Infect., 7, 279–288, https://doi.org/10.5194/jbji-7-279-2022, https://doi.org/10.5194/jbji-7-279-2022, 2022
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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.
Katharine Dobos, Gina A. Suh, Aaron J. Tande, and Shanthi Kappagoda
J. Bone Joint Infect., 7, 137–141, https://doi.org/10.5194/jbji-7-137-2022, https://doi.org/10.5194/jbji-7-137-2022, 2022
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This paper describes five cases of prosthetic joint infection (PJI) caused by Mycobacterium avium complex (MAC). Infections occurred in both immune competent and immunosuppressed patients. Interestingly, using the Musculoskeletal Infection Society diagnostic criteria for PJI may miss some cases of MAC PJI. Treatment courses and outcomes are described.
Diana Salomi Ponraj, Thomas Falstie-Jensen, Nis Pedersen Jørgensen, Christen Ravn, Holger Brüggemann, and Jeppe Lange
J. Bone Joint Infect., 6, 367–378, https://doi.org/10.5194/jbji-6-367-2021, https://doi.org/10.5194/jbji-6-367-2021, 2021
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Implant-associated infections (IAIs) in orthopaedic surgery are associated with high morbidity and mortality. Slow-growing anaerobic bacteria are increasingly being recognized as potential causative agents in such infections, but their diagnosis is difficult. The purpose of this review is to summarize the current knowledge of IAIs with these bacteria. In particular, the review gives an overview of the current methodology in the diagnosis of such infections, to serve as a guide for clinicians.
Cited articles
Aggarwal, V. K., Bakhshi, H., Ecker, N. U., Parvizi, J., Gehrke, T., and Kendoff, D.: Organism profile in periprosthetic joint infection: pathogens differ at two arthroplasty infection referral centers in Europe and in the United States, J. Knee Surg., 27, 399–406, https://doi.org/10.1055/s-0033-1364102, 2014.
Alcobendas, R. M., Udaondo, C., and Calvo, C.: Exclusively Oral Treatment for Osteoarticular Infections in Children. Is It Time?, Iris Publishers Archives of Rheumatology & Arthritis Research – ARAR, 2, https://doi.org/10.33552/ARAR.2023.02.000548, 2023.
Azad, M. A., Wolf, M. J., Strasburg, A. P., Daniels, M. L., Starkey, J. C., Donadio, A. D., Abdel, M. P., Greenwood-Quaintance, K. E., and Patel, R.: Comparison of the BioFire Joint Infection Panel to 16S Ribosomal RNA Gene-Based Targeted Metagenomic Sequencing for Testing Synovial Fluid from Patients with Knee Arthroplasty Failure, J. Clin. Microbiol., 60, e01126-01122, https://doi.org/10.1128/jcm.01126-22, 2022.
Balada-Llasat, J.-M., Stamas, N., Vincent, T., Timbrook, T. T., Saiontz-Martinez, C., Hemmert, R. B., and Berger, A.: Epidemiology and Economic Outcomes Associated with Timely versus Delayed Receipt of Appropriate Antibiotic Therapy among US Patients Hospitalized for Native Septic Arthritis: A Retrospective Cohort Study, Antibiotics, 11, 1732, https://doi.org/10.3390/antibiotics11121732, 2022.
Benito, N., Mur, I., Ribera, A., Soriano, A., Rodríguez-Pardo, D., Sorlí, L., Cobo, J., Fernández-Sampedro, M., Del Toro, M. D., Guío, L., Praena, J., Bahamonde, A., Riera, M., Esteban, J., Baraia-Etxaburu, J. M., Martínez-Alvarez, J., Jover-Sáenz, A., Dueñas, C., Ramos, A., Sobrino, B., Euba, G., Morata, L., Pigrau, C., Horcajada, J. P., Coll, P., Crusi, X., and Ariza, J.: The Different Microbial Etiology of Prosthetic Joint Infections according to Route of Acquisition and Time after Prosthesis Implantation, Including the Role of Multidrug-Resistant Organisms, J. Clin. Med., 8, 673, https://doi.org/10.3390/jcm8050673, 2019.
Berinson, B., Spenke, L., Krivec, L., Tanida, K., Both, A., Keller, J., Rolvien, T., Christner, M., Lütgehetmann, M., Aepfelbacher, M., Klatte, T. O., and Rohde, H.: Performance and Hypothetical Impact on Joint Infection Management of the BioFire Joint Infection Panel: a Retrospective Analysis, J. Clin. Microbiol., 0, e00592-00523, https://doi.org/10.1128/jcm.00592-23, 2023.
bioMérieux: BIOFIRE JI Panel Instructions For Use, https://www.biofiredx.com/support/documents/ (last access: 26 February 2024), 2022.
Costales, C. and Butler-Wu, S. M.: A Real Pain: Diagnostic Quandaries and Septic Arthritis, J. Clin. Microbiol., 56, e01358-01317, https://doi.org/10.1128/jcm.01358-17, 2018.
Cozzi Lepri, A., Del Prete, A., Soderi, S., Innocenti, M., and Civinini, R.: The identification of pathogens associated with periprosthetic joint infection in two-stage revision, Eur. Rev. Med. Pharmacol. Sci., 23, 101–116, https://doi.org/10.26355/eurrev_201904_17480, 2019.
Esteban, J., Salar-Vidal, L., Schmitt, B. H., Waggoner, A., Laurent, F., Abad, L., Bauer, T. W., Mazariegos, I., Balada-Llasat, J.-M., Horn, J., Wolk, D. M., Jefferis, A., Hermans, M., Verhoofstad, I., Butler-Wu, S. M., Umali-Wilcox, M., Murphy, C., Cabrera, B., Craft, D., Bredow, B. v., Leber, A., Everhart, K., Bard, J. D., Flores, I. I., Daly, J., Barr, R., Holmberg, K., Graue, C., and Kensinger, B.: Multicenter evaluation of the BIOFIRE Joint Infection Panel for the detection of bacteria, yeast, and AMR genes in synovial fluid samples, J. Clin. Microbiol., 0, e00357-00323, https://doi.org/10.1128/jcm.00357-23, 2023.
Favero, M., Schiavon, F., Riato, L., Carraro, V., and Punzi, L.: Rheumatoid arthritis is the major risk factor for septic arthritis in rheumatological settings, Autoimmun. Rev., 8, 59–61, https://doi.org/10.1016/j.autrev.2008.07.018, 2008.
Geirsson, A. J., Statkevicius, S., and Víkingsson, A.: Septic arthritis in Iceland 1990-2002: increasing incidence due to iatrogenic infections, Ann. Rheum. Dis., 67, 638–643, https://doi.org/10.1136/ard.2007.077131, 2008.
He, M., Arthur Vithran, D. T., Pan, L., Zeng, H., Yang, G., Lu, B., and Zhang, F.: An update on recent progress of the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis: a review, Front Cell Infect. Microbiol., 13, 1193645, https://doi.org/10.3389/fcimb.2023.1193645, 2023.
Hoffman, T., Kriger, O., Cohen, S., Gefen-Halevi, S., Yahav, D., and Amit, S.: Real-Life Experience and Diagnostic Utility of the BioFire Joint Infection PCR Panel in Bone and Joint Infections: Analysis of a Prospective Validation Study, Infect. Dis. Ther., 12, 1437–1443, https://doi.org/10.1007/s40121-023-00809-x, 2023.
Horowitz, D. L., Katzap, E., Horowitz, S., and Barilla-LaBarca, M. L.: Approach to septic arthritis, Am. Fam. Physician, 84, 653–660, 2011.
Hunter, S., Chan, H., and Baker, J. F.: Global epidemiology of childhood bone and joint infection: a systematic review, Infection, 50, 329–341, https://doi.org/10.1007/s15010-021-01741-3, 2022.
Indelli, P. F., Ghirardelli, S., Valpiana, P., Bini, L., Festini, M., and Iannotti, F.: Debridement, Antibiotic Pearls, and Retention of the Implant (DAPRI) in the Treatment of Early Periprosthetic Joint Infections: A Consecutive Series, Pathogens, 12, 605, https://doi.org/10.3390/pathogens12040605, 2023.
Kleiman, M. B. and Lamb, G. A.: Gonococcal arthritis in a newborn infant, Pediatrics, 52, 285–287, 1973.
Kullar, R., Chisari, E., Snyder, J., Cooper, C., Parvizi, J., and Sniffen, J.: Next-Generation Sequencing Supports Targeted Antibiotic Treatment for Culture Negative Orthopedic Infections, Clin. Infect. Dis., 76, 359–364, https://doi.org/10.1093/cid/ciac733, 2023.
McBride, S., Mowbray, J., Caughey, W., Wong, E., Luey, C., Siddiqui, A., Alexander, Z., Playle, V., Askelund, T., Hopkins, C., Quek, N., Ross, K., Orec, R., Mistry, D., Coomarasamy, C., and Holland, D.: Epidemiology, Management, and Outcomes of Large and Small Native Joint Septic Arthritis in Adults, Clin. Infect. Dis., 70, 271–279, https://doi.org/10.1093/cid/ciz265, 2020.
Moussiegt, A., François, C., Belmonte, O., Jaubert, J., Traversier, N., Picot, S., Josse, F., Guillot, X., Poubeau, P., Moiton, M. P., Bertolotti, A., and Raffray, L.: Gonococcal arthritis: case series of 58 hospital cases, Clin. Rheumatol. 41, 2855–2862, https://doi.org/10.1007/s10067-022-06208-w, 2022.
Patel, R.: Periprosthetic Joint Infection, N. Engl. J. Med., 388, 251–262, https://doi.org/10.1056/NEJMra2203477, 2023.
Peel, T. N., Cheng, A. C., Buising, K. L., and Choong, P. F.: Microbiological aetiology, epidemiology, and clinical profile of prosthetic joint infections: are current antibiotic prophylaxis guidelines effective?, Antimicrob. Agents Chemother., 56, 2386–2391, https://doi.org/10.1128/aac.06246-11, 2012.
Postler, A., Lützner, C., Beyer, F., Tille, E., and Lützner, J.: Analysis of Total Knee Arthroplasty revision causes, BMC Musculoskelet. Disord., 19, 55, https://doi.org/10.1186/s12891-018-1977-y, 2018.
Roerdink, R. L., Huijbregts, H., van Lieshout, A. W. T., Dietvorst, M., and van der Zwaard, B. C.: The difference between native septic arthritis and prosthetic joint infections: A review of literature, J. Orthop. Surg. (Hong Kong), 27, 2309499019860468, https://doi.org/10.1177/2309499019860468, 2019.
Saeed, K., Ahmad-Saeed, N., Annett, R., Barlow, G., Barrett, L., Boyd, S. E., Boran, N., Davies, P., Hughes, H., Jones, G., Leach, L., Lynch, M., Nayar, D., Maloney, R. J., Marsh, M., Milburn, O., Mitchell, S., Moffat, L., Moore, L. S. P., Murphy, M. E., O'Shea, S. A., O'Sullivan, F., Peach, T., Petridou, C., Reidy, N., Selvaratnam, M., Talbot, B., Taylor, V., Wearmouth, D., and Aldridge, C.: A multicentre evaluation and expert recommendations of use of the newly developed BioFire Joint Infection polymerase chain reaction panel, Eur. J. Clin. Microbiol. Infect. Dis., 42, 169–176, https://doi.org/10.1007/s10096-022-04538-w, 2022.
Schoenmakers, J. W. A., de Boer, R., Gard, L., Kampinga, G. A., van Oosten, M., van Dijl, J. M., Jutte, P. C., and Wouthuyzen-Bakker, M.: First evaluation of a commercial multiplex PCR panel for rapid detection of pathogens associated with acute joint infections, J. Bone Joint Infect., 8, 45–50, https://doi.org/10.5194/jbji-8-45-2023, 2023.
Schulz, P., Dlaska, C. E., Perka, C., Trampuz, A., and Renz, N.: Preoperative synovial fluid culture poorly predicts the pathogen causing periprosthetic joint infection, Infection, 49, 427–436, https://doi.org/10.1007/s15010-020-01540-2, 2021.
Signore, A., Sconfienza, L. M., Borens, O., Glaudemans, A. W. J. M., Cassar-Pullicino, V., Trampuz, A., Winkler, H., Gheysens, O., Vanhoenacker, F. M. H. M., Petrosillo, N., and Jutte, P. C.: Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement), Eur. J. Nucl. Med. Mol. Imaging, 46, 971–988, https://doi.org/10.1007/s00259-019-4263-9, 2019.
Smith, J. W., Chalupa, P., and Shabaz Hasan, M.: Infectious arthritis: clinical features, laboratory findings and treatment, Clin. Microbiol. Infect., 12, 309–314, https://doi.org/10.1111/j.1469-0691.2006.01366.x, 2006.
Stefánsdóttir, A., Johansson, D., Knutson, K., Lidgren, L., and Robertsson, O.: Microbiology of the infected knee arthroplasty: report from the Swedish Knee Arthroplasty Register on 426 surgically revised cases, Scand. J. Infect. Dis., 41, 831–840, https://doi.org/10.3109/00365540903186207, 2009.
Tande, A. J. and Patel, R.: Prosthetic joint infection, Clin. Microbiol. Rev., 27, 302–345, https://doi.org/10.1128/cmr.00111-13, 2014.
Weston, V. C., Jones, A. C., Bradbury, N., Fawthrop, F., and Doherty, M.: Clinical features and outcome of septic arthritis in a single UK Health District 1982–1991, Ann. Rheum. Dis., 58, 214–219, https://doi.org/10.1136/ard.58.4.214, 1999.
Wouthuyzen-Bakker, M., Sebillotte, M., Lomas, J., Taylor, A., Palomares, E. B., Murillo, O., Parvizi, J., Shohat, N., Reinoso, J. C., Sánchez, R. E., Fernandez-Sampedro, M., Senneville, E., Huotari, K., Barbero, J. M., Garcia-Cañete, J., Lora-Tamayo, J., Ferrari, M. C., Vaznaisiene, D., Yusuf, E., Aboltins, C., Trebse, R., Salles, M. J., Benito, N., Vila, A., Toro, M. D. D., Kramer, T. S., Petersdorf, S., Diaz-Brito, V., Tufan, Z. K., Sanchez, M., Arvieux, C., and Soriano, A.: Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention, J. Infect., 78, 40–47, https://doi.org/10.1016/j.jinf.2018.07.014, 2019.
Yagupsky, P.: The Past, Present, and Future of Kingella kingae Detection in Pediatric Osteoarthritis, Diagnostics (Basel), 12, 2932, https://doi.org/10.3390/diagnostics12122932, 2022.
Zimmerli, W., Trampuz, A., and Ochsner, P. E.: Prosthetic-joint infections, N. Engl. J. Med., 351, 1645–1654, https://doi.org/10.1056/NEJMra040181, 2004.
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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.
This study conducted in multiple sites across Europe aimed to evaluate the BIOFIRE Joint...
