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Introduction Staphylococcus hyicus is a coagulase-variable Staphylococcus spp. well-known by

Bone and joint infection (BJI) treatment is challenging with significant morbidity and mortality. Dalbavancin is a semi-synthetic lipoglycopeptide analogue of the teicoplanin class that exhibits bactericidal activity and a long half-life. The use of dalbavancin may be an option in cases of gram-positive BJI. From November 2017 to April 2019, dalbavancin was used in monotherapy as a salvage option for BJI, as follows: 1500 mg, 1st (D1) and 8th (D8) days, repeated if needed. The follow-up period was of 6 months for osteomyelitis and 1 year for prosthetic joint infections (PJIs). The demographics of the 16 patients showed that 75% were men (n=12), with a mean age of 77.8 years . The BJI characteristics: 5 cases of vertebral osteomyelitis; 12 cases of lower limb BJI {8 joint infections, among which were 6 PJIs (4 knees, 2 hips) and 4 cases of foot osteomyelitis)}; 2 cases of shoulder PJI. The debridement, antibiotics, irrigation, and implant retention (DAIR) procedure was performed in 83.4% (5/6) of cases. Monobacterial biopsy was obtained in 75% (n=12) of patients with majority of staphylococcus (15/25) dalbavancin susceptible micro-organismes): 14 Staphylococcus aureus (10/14 methicillin susceptible). Twelve patients received 2 doses of dalbavancin. The mean duration of the 1st antibiotherapy was 18.3 days [0-49]. The clinical success rate was 75% at the end of follow-up with no major side effects of dalbavancin. This report highlights the potential role and efficiency of dalbavancin in treating fragile patients who require long-term antimicrobial therapy with excellent tolerance profiles.

BackgroundThe change from non-molecular to nucleic acid amplification tests (NAATs) is known to increase the detection of Clostridium difficile infection (CDI); however, the impact on stool rejection policies in clinical laboratories is unclear. The current guidelines have reinforced the importance of respecting strict conditions for performing tests on stool samples for CDI diagnosis. The purpose of this study was to estimate whether the implementation of molecular tests has resulted in changes in stool rejection policies between clinical laboratories that introduced NAATs and those that did not.ResultsA survey was conducted to evaluate the change in the number of stool samples rejected and the rejection criteria among 12 hospital laboratories in southwestern France before and after the switch from non-molecular tests to NAATs using retrospective data from June 1 till September 30, 2013 and the same period 2014. Four laboratories introduced NAATs as a second or third step in the process. A total of 1378 and 1297 stools samples were collected in 2013 and 2014, respectively. The mean number of rejected stool samples significantly increased (p < 0.001, Chi square test), with a total of 99 (7.1%) and 147 (11.3%) specimens rejected in 2013 and 2014, respectively. Notably, these laboratories had more stringent criteria and were no longer testing the stool samples of patients with CDI-positive results within 7 days. In contrast, there was a significant decrease in the rate of rejected stool samples (p < 0.001, Chi square test) in the five laboratories that did not adopt NAATs and a less stringent stool rejection policy.ConclusionNucleic acid amplification test implementation improved compliance with recommended stool rejection policies. Laboratories should follow the recommended laboratory algorithm for the CDI diagnosis combined with the correct stool rejection policy.Electronic supplementary materialThe online version of this article (10.1186/s13099-018-0245-x) contains supplementary material, which is available to authorized users.

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