A Large Multicenter Study of Methicillin–Susceptible and Methicillin–Resistant Staphylococcus aureus Prosthetic Joint Infections Managed With Implant Retention

Lora‐Tamayo, Jaime; Murillo, Óscar; Iribarren, José Antonio; Soriano, Álex; Sánchez-Somolinos, Mar; Baraia-Etxaburu, Josu; Rico, Alicia; Palomino, Julián; Rodríguez-Pardo, Dolors; Horcajada, Juan Pablo; Benito, Natividad; Bahamonde, Alberto; Granados, A.L. Ortega; Toro, María Dolores del; Cobo, Javier; Riera, Melchor; Ramos, António; Jover-Saénz, Alfredo; Ariza, Javier; Euba, G.; Cabo, Xavier; Pedrero, Salvador; Goenaga, Miguel Ángel; Elola, Maitane; Moreno, Enrique; García-Ramiro, Sebastián; Martínez-Pastor, Juan C.; Tornero, Eduard; García-Lechuz, J.M.; Marı́n, Mercedes; Villanueva, Manuel; López, Iñigo; Cisterna, R; Santamaría, Juan Miguel; Gómez, M L González; Puente, Andrés; Cano, Pedro; Pigrau, Carlos; Sordé, Roger; Flores, Xavier; Sorlí, Luisa; González-Miguez, Paula; Puig, Lluís; Franco, M. Quesada; Jordán, Marcos; Coll, Pere; Amador-Mellado, Juan; Fuster-Foz, Carlos; García-Paíno, Luis; Nieto, Isabel; Muniain, Miguel A.; Suárez, Ana-Isabel; Maseguer, María Antonia; Garagorri, Eduardo; Pintado, Vicente; Marinescu, C.; Ramírez, Antonio; Múñez, Elena; Álvarez, Teresa; García, Rodrigo Jiménez; Barcenilla, Fernando Barroso; Prat, Laura Iogna; Perez, F. Fernandez

doi:10.1093/cid/cis746

Cited by 337 publications

(337 citation statements)

References 31 publications

(73 reference statements)

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“…For this reason, it is considered the drug of choice for the treatment of S. aureus PJI in combination with an appropriate anti-staphylococcal agent to prevent acquisition of resistance [1,2]. However, little data has clearly demonstrated the superiority of rifampicin-based regimens in comparison with other combinations in patients presenting with S. aureus PJI, and there is a debate on the adequate dose for patients presenting with PJI [9,[14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Based on animal experiments and in vitro data, rifampicin-based regimens are recommended for S. aureus PJI [1,2], but rifampicin could be associated with gastrointestinal disorders, drug-drug interactions, and the dose for patients presenting with PJI is debated (600 mg/d irrespective of the weight in Spain, 600 to 900 mg/d in the IDSA guidelines, 20 mg/kg/d in the French guidelines) [1,2,8,9]. Methicillin-resistant S. aureus (MRSA) is considered more difficult to treat as it is usually resistant to many clinically important non-beta-lactam drugs, such as rifampicin and fluoroquinolones.…”

Section: Introductionmentioning

confidence: 99%

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Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure

Bouaziz

Uçkay

Lustig

et al. 2018

Médecine et Maladies Infectieuses

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Please cite this article in press as: Bouaziz A, et al. Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure. AbstractObjective. -The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known.Patients and methods. -Retrospective (2000-2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure.Results. -Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associated with treatment failure (hazard ratio 2.157; 95% CI [1. 022-4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy, and a rifampicin-based regimen did not significantly influence patient outcome.Conclusion. -Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implant removal is needed to limit treatment failure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure

Bouaziz

Uçkay

Lustig

et al. 2018

Médecine et Maladies Infectieuses

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“…The majority of implanted medical device infections are caused by staphylococcal species, including methicillin-resistant Staphylococcus aureus (MRSA) (1,2,4). Systemic administration of vancomycin (Van) plus rifampin (Rif) is recommended in clinical practice guidelines to treat these infections (14-16) because combinatorial therapy with Rif has an added therapeutic benefit (27,28). Newer antistaphylococcal agents such as linezolid (Lin) and daptomycin (Dap) are also used to cover MRSA (29).…”

Section: Resultsmentioning

confidence: 99%

Polymeric nanofiber coating with tunable combinatorial antibiotic delivery prevents biofilm-associated infection in vivo

Ashbaugh

Jiang

Zheng

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Bacterial biofilm formation is a major complication of implantable medical devices that results in therapeutically challenging chronic infections, especially in cases involving antibiotic-resistant bacteria.As an approach to prevent these infections, an electrospun composite coating comprised of poly(lactic-coglycolic acid) (PLGA) nanofibers embedded in a poly(e-caprolactone) (PCL) film was developed to locally codeliver combinatorial antibiotics from the implant surface. The release of each antibiotic could be adjusted by loading each drug into the different polymers or by varying PLGA:PCL polymer ratios. In a mouse model of biofilm-associated orthopedic-implant infection, three different combinations of antibiotic-loaded coatings were highly effective in preventing infection of the bone/joint tissue and implant biofilm formation and were biocompatible with enhanced osseointegration. This nanofiber composite-coating technology could be used to tailor the delivery of combinatorial antimicrobial agents from various metallic implantable devices or prostheses to effectively decrease biofilm-associated infections in patients.nanofiber | biofilm | infection | antibiotic | delivery

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“…However, the purpose of the present study was to evaluate only studies reporting on hip joint infections. Several well-designed studies with a higher level of evidence report about DAIR including both THA and total knee arthroplasty (TKA) cases, whereas a differentiation of the results between both primary surgeries is not possible [15][16][17][18][19][20][21][22][23][24][25][26][27][28] . Similar to that, other studies present data only about small case series [29][30][31] .…”

mentioning

confidence: 99%

“…Various risk factors have been described that are associated with occurrence of PJI, such as rheumatoid arthritis, diabetes mellitus, malignancy, obesity, and use of immunosuppressive drugs [15,20,[32][33][34] . Revision surgery also increases the conclusions.…”

mentioning

confidence: 99%

Can periprosthetic hip joint infections be successfully managed by debridement and prosthesis retention?

Anagnostakos

Schmitt

2014

WJO

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To evaluate the current literature about how successfully periprosthetic hip joint infections can be managed by debridement and prosthesis retention. A literature search was performed through PubMed until September 2013. Search terms were "DAIR (debridement, antibiotics, irrigation, and retention)" alone and in combination with "hip" as well as "hip infection + prosthesis retention". A total of 11 studies reporting on 292 cases could be identified. Five different treatment modalities have been described with varying success rates (debridement-21% infection eradication rate; debridement + lavage-75% infection eradication rate; debridement, lavage, with change of modular prosthesis components-70.4% infection eradication rate; debridement, lavage, change of modular prosthesis components + vacuum-assisted closure-92.8% infection eradication rate; acetabular cup removal + spacer head onto retained stem-89.6% infection eradication rate). With regard to the postoperative antibiotic therapy, no general consensus could be drawn from the available data. Debridement, antibiotic therapy, irrigation, and prosthesis retention is an acceptable solution in the management of early and acute hematogenous periprosthetic hip joint infections. The current literature does not allow for generalization of conclusions with regard to the best treatment modality. A large, multi-center study is required for identification of the optimal treatment of these infections.

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A Large Multicenter Study of Methicillin–Susceptible and Methicillin–Resistant Staphylococcus aureus Prosthetic Joint Infections Managed With Implant Retention

Abstract: This is the largest series of PJI by S. aureus managed with DAIR reported to date. The success rate was 55%. The use of rifampin may have contributed to homogenizing MSSA and MRSA prognoses, although the specific rifampin combinations may have had different efficacies.

Cited by 337 publications

References 31 publications

Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure

Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure

Polymeric nanofiber coating with tunable combinatorial antibiotic delivery prevents biofilm-associated infection in vivo

Can periprosthetic hip joint infections be successfully managed by debridement and prosthesis retention?

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