Low-Virulence Organisms and Periprosthetic Joint Infection—Biofilm Considerations of These Organisms

Boyle, K. Keely; Wood, S.A.; Tarity, T. David

doi:10.1007/s12178-018-9503-2

Cited by 35 publications

(24 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A review of tissue histology and causative micro-organisms identified from intra-operative samples confirmed that patients included in this study met MSIS criteria for PJI. For purposes of analysis, microorganisms were classified based on those generally considered to be high-virulence or low-virulence [24][25][26]. Patients were also assigned retrospectively a systemic host grade according to the McPherson staging system, in which grade A is an uncompromised host, grade B is a compromised host with one to two compromising systemic factors, and grade C is a substantially compromised host with more than two compromising systemic factors [27,28].…”

Section: Methodsmentioning

confidence: 99%

Early Peri-Prosthetic Joint Infection after Hemiarthroplasty for Hip Fracture: Outcomes of Debridement, Antibiotics, and Implant Retention

Yassin

Sharma

Butt

et al. 2020

Surgical Infections

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

Early Peri-Prosthetic Joint Infection after Hemiarthroplasty for Hip Fracture: Outcomes of Debridement, Antibiotics, and Implant Retention

Yassin

Sharma

Butt

et al. 2020

Surgical Infections

View full text Add to dashboard Cite

“…While in the first case Staphylococcus aureus is responsible for more than 50% of the cases, prosthetic joint infections (PJIs) see a very high incidence of low-virulence microorganisms, such as coagulase-negative staphylococci (CoNS) and anaerobes such as Cutibacterium acnes (Drago et al, 2017). Indeed the pathogenicity of such opportunistic species mainly relies on their ability to adhere to abiotic surfaces and to form mature biofilm by producing or incorporating polymeric substances (Boyle et al, 2018). As a consequence of this protected mode of growth, the sessile microbes become resilient to antibiotics and the immune system.…”

Section: Introductionmentioning

confidence: 99%

Identification and Characterization of Planktonic Biofilm-Like Aggregates in Infected Synovial Fluids From Joint Infections

et al. 2020

View full text Add to dashboard Cite

Recent in vitro studies reported the exceptional ability of some bacterial species to form biofilm-like aggregates in human and animal synovial fluids (SF), but evidences from infected clinical samples are still lacking. In this study, we investigated whether this bacterial phenotype was present in infected SFs collected from joint infections and if it was maintained in in vitro settings. SFs sent for culture to the Laboratory of Microbiology of our institute were directly analyzed by means of confocal laser scanning microscopy (CLSM), and the infective agents were isolated for further in vitro tests. Moreover, sterile SF was collected from patients who did not receive previous antibiotic therapy to investigate the formation of bacterial aggregates, together with biofilm and matrix production on a titanium surface. Finally, antibiotic susceptibility studies were performed by using bovine SF. Four Staphylococcus aureus, one Staphylococcus lugdunensis, and one Prevotella bivia strain were identified in the infected SFs. The CLSM analysis showed that all staphylococci were present as a mixture of single cells and bacterial clumps surrounded by an exopolymeric substance, which comprised SF-derived fibrin, while all P. bivia cells appeared separated. Despite that, differences in the ability to aggregate between S. aureus and S. lugdunensis were observed in clinical SFs. These different phenotypes were further confirmed by in vitro growth, even though the application of such ex vivo approach lead all staphylococci to form exceptionally large microbial aggregates, which are several folds bigger than those observed in clinical samples. Planktonic aggregates challenged for antibiotic susceptibility revealed a sharp increase of recalcitrance to the treatments. Although this is still at a preliminary stage, the present work confirmed the ability of staphylococci to form free-floating biofilm-like aggregates in infected SF from patients with joint infections. Furthermore, the obtained results pointed out that future in vitro research on joint infections will benefit from the use of human-or animal-derived SF. Even though this approach should be carefully validated in further studies comprising a larger microbial population, these findings pose new challenges in the treatment of infected native and prosthetic joints and for the approach to new investigations.

show abstract

“…Five of the 11 patients (45%) who underwent invasive procedures before definitive surgery unexpectedly had either an erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) at normal or near-normal levels. In addition, 7 of 25 (28%) patients ultimately had infection with a low-virulence organism [ 7 ], and 4 of 25 (16%) showed a culture-negative infection based on intraoperative cultures.…”

Section: Resultsmentioning

confidence: 99%

Management of Periprosthetic Hip and Knee Joint Infections With a Known Sinus Tract—A Single-Center Experience

et al. 2021

View full text Add to dashboard Cite

Background: Prosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). A sinus tract communicating with a prosthetic joint is a major criterion defining PJI. Despite this fact, many patients presenting with a draining sinus tract undergo invasive procedures before initiation of twostage revision arthroplasty. We hypothesized that many patients undergo nondefinitive procedures to treat the sinus tract, rather than undergoing definitive treatment of infection with two-stage revision. Methods: A retrospective review of all cases of two-stage revision arthroplasty at Loyola University Medical Center between January 2004 and May 2018 was performed. Patients with infected TJA and periprosthetic sinus tract were included. Records were queried for laboratory values and prior procedures. Results: We identified 160 patients who underwent two-stage revision for infection over the 14-year period. Of the 160 patients, 25 had a documented periprosthetic sinus tract before initiation of definitive revision arthroplasty and were included. Eleven (44.0%) had one or more procedures including interventional radiology drain placement, local wound care, or formal irrigation and debridement before definitive treatment. Forty-five percent of patients that underwent nondefinitive procedures before definitive surgery had either an erythrocyte sedimentation rate or C-reactive protein at normal or nearnormal levels. Conclusion: Many arthroplasty patients presenting with periprosthetic sinus tracts undergo nondefinitive procedures before definitive treatment. Inherent surgical risks of these procedures can increase the overall morbidity and mortality of these patients. Further effort is needed to educate surgeons regarding management of sinus tracts after TJA.

show abstract

Low-Virulence Organisms and Periprosthetic Joint Infection—Biofilm Considerations of These Organisms

Cited by 35 publications

References 80 publications

Early Peri-Prosthetic Joint Infection after Hemiarthroplasty for Hip Fracture: Outcomes of Debridement, Antibiotics, and Implant Retention

Early Peri-Prosthetic Joint Infection after Hemiarthroplasty for Hip Fracture: Outcomes of Debridement, Antibiotics, and Implant Retention

Identification and Characterization of Planktonic Biofilm-Like Aggregates in Infected Synovial Fluids From Joint Infections

Management of Periprosthetic Hip and Knee Joint Infections With a Known Sinus Tract—A Single-Center Experience

Contact Info

Product

Resources

About