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2021

Management of prosthetic joint infections in France: a national audit to identify key situations requiring innovation and homogenization
BMC Infect Dis. 2021 May 1;21(1):401. doi: 10.1186/s12879-021-06075-x.
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Background: Prosthetic joint infections (PJI) are one of the most serious complication of arthroplasty. The management of PJI needs a multidisciplinary collaboration between orthopaedic surgeon, infectious disease specialist and microbiologist. In France, the management of PJI is organized around reference centres (CRIOACs). Our main objective was to perform an audit through a questionnaire survey based... Read more »
Pharmacokinetic/Pharmacodynamic Dosage Individualization of Suppressive Beta-Lactam Therapy Administered by Subcutaneous Route in Patients With Prosthetic Joint Infection
Front Med (Lausanne). 2021 Mar 31;8:583086. doi: 10.3389/fmed.2021.583086. eCollection 2021.
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Suppressive parenteral antibiotic therapy with beta-lactams may be necessary in patients with Gram-negative bone and joint infection (BJI). Subcutaneous drug administration can facilitate this therapy in outpatient setting, but there is limited information about this practice. We have developed an original approach for drug dosing in this context, based on therapeutic drug monitoring (TDM) and... Read more »

2020

Septic Arthritis of Facet Joint in Children: A Systematic Review and a 10-year Consecutive Case Series
Pediatr Infect Dis J . 2020 Dec 23. doi: 10.1097/INF.0000000000003031. Online ahead of print.
international
Background: Due to the low resolution of historical imaging technologies, descriptions of Septic Arthritis of Facet Joint (SAFJ) in children are scarce, though severe cases are known. We first aimed to estimate the incidence rate of SAFJ in children; we further aimed to specify SAFJ clinical, imaging and laboratory findings, and identify avenues for appropriate... Read more »
Population pharmacokinetics of daptomycin in patients with bone and joint infection: minimal effect of rifampicin co-administration and confirmation of a sex difference
J Antimicrob Chemother . 2021 Feb 7;dkab006. doi: 10.1093/jac/dkab006. Online ahead of print.
international
Background: Daptomycin is increasingly used in the treatment of bone and joint infection (BJI), but its pharmacokinetics (PK) and dosage requirements have not been thoroughly investigated in this indication. Daptomycin may be co-administered with rifampicin, which raises questions about a potential drug interaction. Objectives: To investigate the population PK and dosage requirements of daptomycin in... Read more »
Antibiotics in Bone Cements Used for Prosthesis Fixation: An Efficient Way to Prevent Staphylococcus aureus and Staphylococcus epidermidis Prosthetic Joint Infection
Front Med (Lausanne) . 2021 Jan 20;7:576231. doi: 10.3389/fmed.2020.576231. eCollection 2020.
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Prosthetic joint infections (PJIs) are one of the most frequent reasons for arthroplasty revision. These infections are mostly associated with the formation of biofilm, notably by staphylococci, such as Staphylococcus aureus and Staphylococcus epidermidis. To minimize the rates of PJIs following primary or revision total joint arthroplasty, antibiotic-loaded bone cements (ALBCs) can be used for prosthesis fixation. However,... Read more »
Bone and Joint Infection Involving Corynebacterium spp.: From Clinical Features to Pathophysiological Pathways
Front Med (Lausanne) . 2021 Jan 21;7:539501. doi: 10.3389/fmed.2020.539501. eCollection 2020.
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Introduction: Corynebacteria represent often-neglected etiological agents of post-traumatic and/or post-operative bone and joint infection (BJI). We describe here clinical characteristics and bacteriological determinants of this condition. Methods: A retrospective cohort study described characteristics, outcome and determinants of treatment failure of all patients with proven Corynebacterium spp. BJI (i.e., ≥2 culture-positive gold-standard samples). Available strains were further characterized... Read more »
Outpatient Subcutaneous Antimicrobial Therapy (OSCAT) as a Measure to Improve the Quality and Efficiency of Healthcare Delivery for Patients With Serious Bacterial Infections
Front Med (Lausanne) . 2020 Dec 23;7:585658. doi: 10.3389/fmed.2020.585658. eCollection 2020.
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Since the 1970s, outpatient parenteral antimicrobial therapy (OPAT) has been a viable option for patients who require intravenous antibiotics when hospitalization is not warranted. While the benefits of OPAT as a measure to improve the efficiency of healthcare delivery (i.e., reduced hospital days) and patient satisfaction are well-documented, OPAT is associated with a number of... Read more »
Epidemiology of complex bone and joint infections in France using a national registry: The CRIOAc network
J Infect . 2020 Dec 19;S0163-4453(20)30771-4. doi: 10.1016/j.jinf.2020.12.010.
international
Objectives: In France, a network of reference centers for bone and joint infections (BJI) was created in 2008, focused on the management of complex BJI (previous failure, difficult-to-treat microorganisms, heavy comorbidities or surgical procedures). A national registry was implemented from 2012, collecting decisions advised in periodic multidisciplinary meetings. We present here an epidemiological overview. Methods:... Read more »
Tolerance of Prolonged Oral Tedizolid for Prosthetic Joint Infections: Results of a Multicentre Prospective Study
Antibiotics (Basel) . 2020 Dec 23;10(1):E4. doi: 10.3390/antibiotics10010004.
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Objectives: Data on clinical and biological tolerance of tedizolid (TZD) prolonged therapy are lacking. Methods: We conducted a prospective multicentre study including patients with prosthetic joint infections (PJIs) who were treated for at least 6 weeks but not more than 12 weeks. Results: Thirty-three adult patients of mean age 73.3 ± 10.5 years, with PJI... Read more »
Anemia before reimplantation surgery : An overlooked modifiable risk factor of septic revision knee arthroplasty failure
SICOT J . 2020;6:47. doi: 10.1051/sicotj/2020046. Epub 2020 Dec 11.
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Introduction: Preoperative anemia in patients undergoing a two-stage septic revision arthroplasty may be a factor of reinfection, even in the presence of aggressive antimicrobial therapy. Patient Blood Management (PBM) in such patients is challenging. We evaluate the impact of anemia existing before re-implantation on a failure rate after two-stage septic total knee arthroplasty (rTKA), and... Read more »
Phage Therapy as Adjuvant to Conservative Surgery and Antibiotics to Salvage Patients With Relapsing S. aureus Prosthetic Knee Infection
Front. Med., 16 November 2020 | https://doi.org/10.3389/fmed.2020.570572
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Objectives: To report the management of three consecutive patients with relapsing Staphylococcus aureus prosthetic knee infection (PKI) for whom explantation was not feasible who received a phage therapy during a “Debridement Antibiotics and Implant Retention” (DAIR) procedure followed by suppressive antimicrobial therapy. Methods: Each case was discussed individually in our reference center and with the French National... Read more »
Computerized registry as a potential tool for surveillance and management of complex bone and joint infections in France: French registry of complex bone and joint infections.
Bone Joint Res . 2020 Oct 10;9(10):635-644. doi: 10.1302/2046-3758.910.BJR-2019-0362.R1. eCollection 2020 Oct.
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Aims: The French registry for complex bone and joint infections (C-BJIs) was created in 2012 in order to facilitate a homogeneous management of patients presented for multidisciplinary advice in referral centres for C-BJI, to monitor their activity and to produce epidemiological data. We aimed here to present the genesis and characteristics of this national registry... Read more »
Pseudomonas aeruginosa Implant-Associated Bone and Joint Infections: Experience in a Regional Reference Center in France
Front. Med., 26 October 2020| https://doi.org/10.3389/fmed.2020.513242
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Background: P. aeruginosa implant-associated bone and joint infections (BJI) is considered to be one of the most difficult to treat BJI. The data focusing specifically on this pathogen are sparse, and it seems difficult to extrapolate the results obtained with Enterobacteriaceae. Methods: We performed a retrospective observation study of all P. aeruginosa implant-associated BJI diagnosed... Read more »
Why Reintervention After Total Knee Arthroplasty Fails? A Consecutive Cohort of 1170 Surgeries
J Arthroplasty . 2020 Sep;35(9):2550-2560. doi: 10.1016/j.arth.2020.04.043. Epub 2020 Apr 21.
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Background: The aim of this study was to analyze why contemporary reintervention after total knee arthroplasty (RiTKA) fails. Methods: Between January 2006 and December 2010, from a multicenter cohort of 1170 RiTKAs, we assessed all failures of RiTKA requiring additional surgery. All indications for the index reintervention were included. The minimum follow-up period was 3... Read more »
Medical innovations to maintain the function in patients with chronic PJI for whom explantation is not desirable: a pathophysiology-, multidisciplinary-, and experience-based approach
SICOT J . 2020;6:26. doi: 10.1051/sicotj/2020021. Epub 2020 Jul 7.
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Introduction: PJI is the most dramatic complication after joint arthroplasty. In patients with chronic infection, prosthesis exchange is in theory the rule. However, this surgical approach is sometimes not desirable especially in elderly patients with multiple comorbidities, as it could be associated with a dramatic loss of function, reduction of the bone stock, fracture, or... Read more »
Plasma Cell Infiltration on Histopathological Samples of Chronic Bone and Joint Infections due to Cutibacterium acnes: A series of 21 Cases
J Bone Jt Infect . 2020 Jun 23;5(4):205-211. doi: 10.7150/jbji.46187. eCollection 2020.
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Introduction: Histopathological definition of bone and joint infection (BJI) is based on Mirra’s criterion (≥ 5 polymorphonuclears (PMNs) per field in 5 high power fields (HPFs)). However, this definition does not seem appropriate for chronic BJIs caused by slow-growing germs such as Cutibacterium acnes (C. acnes). The aim of this study was to confirm that... Read more »
Hematogenous osteomyelitis in childhood can relapse many years later into adulthood
Medicine (Baltimore) . 2020 May;99(20):e19617.
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To describe the epidemiological, clinical, laboratory, and radiological features and the management of adult patients who experienced a relapse between 2003 and 2015 of an acute hematogenous osteomyelitis acquired in childhood. A retrospective multicentric cohort study was conducted in 5 centers in France. Thirty-seven patients were included. The median age was 40 years (28–56), and... Read more »
Tolerance and Microbiological Efficacy of Cefepime or piperacillin/tazobactam in Combination With Vancomycin as Empirical Antimicrobial Therapy of Prosthetic Joint Infection: A Propensity-Matched Cohort Study
J Antimicrob Chemother . 2020 May 14;dkaa166. doi: 10.1093/jac/dkaa166.
international
Background: The use of piperacillin/tazobactam with vancomycin as empirical antimicrobial therapy (EAT) for prosthetic joint infection (PJI) has been associated with an increased risk of acute kidney injury (AKI), leading us to propose cefepime as an alternative since 2017 in our reference centre. Objectives: To compare microbiological efficacy and tolerance of these two EAT strategies.... Read more »
Efficacy of Bacteriophages in a Staphylococcus aureus Nondiabetic or Diabetic Foot Infection Murine Model
Antimicrob Agents Chemother. 2020 Jan 27;64(2). pii: e01870-19. doi: 10.1128/AAC.01870-19. Print 2020 Jan 27.
international
This study investigated the in vivo efficacy of three bacteriophages combined compared with linezolid in two mouse models (nondiabetic and diabetic) of Staphylococcus aureus foot infection. In both models, a single injection of bacteriophages in the hindpaw showed significant antibacterial efficacy. Linezolid was as effective as bacteriophages in nondiabetic animals but ineffective in diabetic animals. These findings further support... Read more »
Evaluation of the Activity of a Combination of Three Bacteriophages Alone or in Association with Antibiotics on Staphylococcus aureus Embedded in Biofilm or Internalized in Osteoblasts
Antimicrob Agents Chemother. 2020 Feb 21;64(3). pii: e02231-19. doi: 10.1128/AAC.02231-19. Print 2020 Feb 21.
international
Staphylococcus aureus is responsible for difficult-to-treat bone and joint infections (BJIs). This is related to its ability to form biofilm and to be internalized and persist inside osteoblasts. Recently, bacteriophage therapy has emerged as a promising option to improve treatment of such infections, but data on its activity against the specific bacterial lifestyles presented above remain... Read more »
Duration of rifampin therapy is a key determinant of improved outcomes in early-onset acute prosthetic joint infection due to Staphylococcus treated with a debridement, antibiotics and implant retention (DAIR): a retrospective multicenter study in France
J Bone Jt Infect. 2020 Feb 10;5(1):28-34. doi: 10.7150/jbji.40333. eCollection 2020.
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Introduction: In patients undergoing a « debridement, antibiotics, and implant retention » (DAIR) procedure for acute staphylococcal prosthetic joint infection (PJI), post-operative treatment with rifampin has been associated with a higher probability of success.(1,2) However, it is not known whether it is the total dose, delay of introduction or length of therapy with rifampin that... Read more »
Antibiofilm and intraosteoblastic activities of rifamycins against Staphylococcus aureus: promising in vitro profile of rifabutin
J Antimicrob Chemother. 2020 Mar 3. pii: dkaa061. doi: 10.1093/jac/dkaa061
international
BACKGROUND: Targeting biofilm-embedded and intraosteoblastic Staphylococcus aureus, rifampicin gained a pivotal role in bone and joint infection (BJI) treatment. Two other rifamycins, rifabutin and rifapentine, may represent better-tolerated alternatives, but their activity against bacterial reservoirs associated with BJI chronicity has never been evaluated. OBJECTIVES: To evaluate the activities of rifampicin, rifabutin and rifapentine in osteoblast... Read more »

2019

The CRIOAc healthcare network in France: A nationwide Health Ministry program to improve the management of bone and joint infection
Orthop Traumatol Surg Res. 2019 Feb;105(1):185-190. doi: 10.1016/j.otsr.2018.09.016. Epub 2018 Nov 6.
international
Background Bone and joint infections (BJIs) have a major clinical and economic impact in industrializedcountries. Its management requires a multidisciplinary approach, and a great experience for the mostcomplicated cases to limit treatment failure, motor disability and amputation risk. To our best knowledgethere is not currently national specific organization dedicated to manage BJI. Is it possible... Read more »
Subcutaneous suppressive antibiotic therapy for bone and joint infections: safety and outcome in a cohort of 10 patients
J Antimicrob Chemother 2019; 74: 2060–2064 doi:10.1093/jac/dkz104
international
Background Optimal treatment of prosthetic joint infection and chronic osteomyelitis consists of surgical removal of biofilm-embedded bacteria, followed by a 6–12 week course of antimicrobial therapy. However, when optimal surgery is not feasible, oral prolonged suppressive antibiotic therapy (PSAT) is recommended to prevent prosthesis loosening and/or relapse of infection. Since 2010, we have used infection... Read more »
Subcutaneous teicoplanin in staphylococcal bone and joint infections
Med Mal Infect. 2019 Nov 3. pii: S0399-077X(18)30695-4. doi: 10.1016/j.medmal.2019.10.002.
international
Objective We aimed to describe the use of subcutaneous teicoplanin as an alternative for the treatment of staphylococcal bone and joint infections. Methods A retrospective multicentric cohort (2002–2015) was conducted with patients receiving sub-cutaneous teicoplanin for a staphylococcal bone and joint infection.Results. – Forty patients were assessed. A median loading dose of 9.4 mg/kg/12 h... Read more »
Pubic osteomyelitis: Epidemiology and factors associated with treatment failure
Med Mal Infect. 2019 Nov 18. pii: S0399-077X(19)31064-9. doi: 10.1016/j.medmal.2019.10.012.
international
Objective To describe the epidemiology of pubic osteomyelitis (PO) and to look for factors associatedwith treatment failure. Method Retrospective study describing PO according to outcome: success or failure of initial man-agement. Factors associated with failure determined by univariate Cox analysis. Kaplan-Meier curvecompared between groups by log-rank test.Results. – Twenty-five patients were included over a 13-year... Read more »
Interaction Between Staphylococcal Biofilm and Bone: How Does the Presence of Biofilm Promote Prosthesis Loosening?
Send to Front Microbiol. 2019 Jul 17;10:1602. doi: 10.3389/fmicb.2019.01602. eCollection 2019.
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With the aging of population, the number of indications for total joint replacement is continuously increasing. However, prosthesis loosening can happen and is related to two major mechanisms: (1) aseptic loosening due to prosthesis micromotion and/or corrosion and release of wear particles from the different components of the implanted material and (2) septic loosening due... Read more »
Evaluation of the ability of linezolid and tedizolid to eradicate intraosteoblastic and biofilm-embedded Staphylococcus aureus in the bone and joint infection setting
J Antimicrob Chemother 2019; 74: 625–632 doi:10.1093/jac/dky473
international
Objectives: Prolonged use of linezolid for bone and joint infection (BJI) is limited by its long-term toxicity. The better safety profile of tedizolid, a recently developed oxazolidinone, could offer an alternative. However, its efficacy against biofilm-embedded and intracellular Staphylococcus aureus, the two main bacterial reservoirs associated with BJI chronicity, is unknown. Methods: Using three S.... Read more »
Efficacy of bacteriophages in a S. aureus non-diabetic or diabetic foot infection murine model
Antimicrob Agents Chemother. 2019 Nov 11. pii: AAC.01870-19. doi: 10.1128/AAC.01870-19
international
This study investigated the in vivo efficiency of three combined bacteriophages compared to linezolid, in two mouse models (non-diabetic or diabetic) of S. aureus foot infection. In both models, a single injection of bacteriophages showed a significant antibacterial efficacy in the hindpaw. Linezolid was as effective as bacteriophages in non-diabetic animals but ineffective in diabetic animals. These findings support... Read more »
Microbiologic epidemiology depending on time to occurrence of prosthetic joint infection: a prospective cohort study
Clin Microbiol Infect . 2019 Mar;25(3):353-358. doi: 10.1016/j.cmi.2018.04.035. Epub 2018 May 25.
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OBJECTIVES: The high microbiologic diversity encountered in prosthetic joint infection (PJI) makes the choice of empirical antimicrobial therapies challenging, especially in cases of implant retention or one-stage exchange. Despite the risk of dysbiosis and toxicity, the combination of vancomycin with a broad-spectrum β-lactam is currently recommended in all cases, even if Gram-negative bacilli (GNB) might be less represented in late PJI.... Read more »

2018

Cefoxitin: Interesting Perspectives on a Neglected Intravenous Beta-lactam
Mediterr J Infect Microb Antimicrob 2018;7:36. doi: 10.4274/mjima.2018.36
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Cefoxitin is a beta-lactam antibiotic belonging to the cephamycins class, up to now only used in clinical practice for prophylaxis during surgery. Recently, its use has increased due to the spread of infections caused by extended-spectrum beta-lactamase-producing bacteria, particularly urinary tract infections. It has a broad antimicrobial spectrum and is also effective in polymicrobial bone... Read more »
Salvage Debridement, Antibiotics and Implant Retention (“DAIR”) With Local Injection of a Selected Cocktail of Bacteriophages: Is It an Option for an Elderly Patient With Relapsing Staphylococcus aureus Prosthetic-Joint Infection?
Open Forum Infect Dis. 2018 Oct 24;5(11):ofy269. doi: 10.1093/ofid/ofy269. eCollection 2018 Nov
free access international
Local injection of a bacteriophages mix during debridement, antibiotics and implant retention (“DAIR”) was performed to treat a relapsing Staphylococcus aureus chronic prosthetic joint infection (PJI). This salvage treatment was safe and associated with a clinical success. Scientific evaluation of the potential clinical benefit of bacteriophages as antibiofilm treatment in PJI is now feasible and... Read more »
Non-compliance with IDSA guidelines for patients presenting with methicillin-susceptible Staphylococcus aureus prosthetic joint infection is a risk factor for treatment failure
Med Mal Infect. 2018 May;48(3):207-211. doi: 10.1016/j.medmal.2017.09.016. Epub 2017 Nov 6.
international
Objective: The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptibleS. 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 Coxanalysis was performed to determine if the non-compliance with IDSA surgical... Read more »
Association between biofilm formation phenotype and clonal lineage in Staphylococcus aureus strains from bone and joint infections
PLoS One. 2018 Aug 30;13(8):e0200064. doi: 10.1371/journal.pone.0200064. eCollection 2018.
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Biofilm formation is a critical virulence factor responsible for treatment failure and chronicity in orthopaedic device-related infections (ODIs) caused by Staphylococcus aureus. Clonal lineages differ in terms of their biofilm forming capacities. The aim of this study was to investigate the correlation between the clonal complex (CC) affiliation and biofilm phenotype of 30 clinical S. aureus isolates responsible of ODI based on i) early biofilm formation using BioFilm Ring Test® and mature biofilm formation using crystal violet assays,... Read more »
Prospective Cohort Study of the Tolerability of Prosthetic Joint Infection Empirical Antimicrobial Therapy
Antimicrob Agents Chemother. 2018 Sep 24;62(10). pii: e00163-18. doi: 10.1128/AAC.00163-18. Print 2018 Oct.
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The empirical use of vancomycin in combination with a broad-spectrum beta-lactam is currently recommended after the initial surgery of prosthetic joint infection (PJI). However, the tolerability of such high-dose intravenous regimens is poorly known. Adult patients receiving an empirical antimicrobial therapy (EAT) for a PJI were enrolled in a prospective cohort study (2011 to 2016). EAT-related adverse events (AE) were described according to the common terminology criteria for AE (CTCAE),... Read more »
Prolonged Cefoxitin Infusion Using Mobile Elastomeric Infusors In Outpatients With Bone And Joint Infection
J Bone Jt Infect. 2018 Sep 7;3(4):182-186. doi: 10.7150/jbji.27718. eCollection 2018.
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We reviewed all outpatients with bone and joint infection treated with cefoxitin in continuous intravenous infusion using mobile elastomeric infusors in our regional reference center between 2014 and 2017. The stability of cefoxitin provides an interesting and well-tolerated alternative for continuous infusion in outpatients with polymicrobial bone and joint infection.
Erysipelas or cellulitis with a prosthetic joint in situ
J Bone Jt Infect. 2018 Oct 4;3(4):222-225. doi: 10.7150/jbji.25519. eCollection 2018.
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We describe a case of a 60-year old male who developed an acute prosthetic joint infection (PJI) of the knee, secondary to erysipelas of the lower leg due to beta-hemolytic Group G streptococci. As it is unknown how often this phenomenon occurs in patients with prosthetic implants and which patients are most prone to develop this complication, we... Read more »
Outpatient parenteral antibiotic therapy: Evaluation of practices and limits of use in rural areas in France
Med Mal Infect. 2018 Mar;48(2):130-135. doi: 10.1016/j.medmal.2017.09.008. Epub 2017 Oct 16.
international
OBJECTIVES To evaluate outpatient parenteral antibiotic therapy (OPAT) practices in a French rural area. MATERIAL AND METHODS Descriptive study assessing knowledge, practices, and limitations of OPAT use among hospital practitioners (HP), family physicians (FP), and private nurses (PN). RESULTS OPAT (mainly ceftriaxone and penicillins) was used by 69.6%, 73.3%, and 97.7% of the 23 HPs, 45... Read more »
Population pharmacokinetics and probability of target attainment of ertapenem administered by subcutaneous or intravenous route in patients with bone and joint infection
J Antimicrob Chemother. 2018 Apr 1;73(4):987-994. doi: 10.1093/jac/dkx477.
international
BACKGROUND: Ertapenem is a therapeutic option in patients with Gram-negative bone and joint infection (BJI). The subcutaneous (sc) route of administration is convenient in the outpatient setting and has shown favourable pharmacokinetics (PK), but available data on ertapenem are limited. OBJECTIVES: To perform population PK analysis and pharmacokinetic/pharmacodynamic (PK/PD) simulation of ertapenem administered by the intravenous (iv) or... Read more »
Pressure ulcer-related pelvic osteomyelitis: evaluation of a two-stage surgical strategy (debridement, negative pressure therapy and flap coverage) with prolonged antimicrobial therapy
BMC Infect Dis. 2018 Apr 10;18(1):166. doi: 10.1186/s12879-018-3076-y
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Background A two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitis but has not been widely evaluated. Methods Adult patients with pressure ulcer-related pelvic osteomyelitis treated by a two-stage surgical strategy were included in a retrospective cohort study. Determinants of superinfection (i.e.,... Read more »
Salvage Debridement, Antibiotics and Implant Retention (“DAIR”) With Local Injection of a Selected Cocktail of Bacteriophages: Is It an Option for an Elderly Patient With Relapsing Staphylococcus aureus Prosthetic-Joint Infection?
Open Forum Infect Dis. 2018 Oct 24;5(11):ofy269. doi: 10.1093/ofid/ofy269. eCollection 2018 Nov.
free access international
Local injection of a bacteriophages mix during debridement, antibiotics and implant retention (“DAIR”) was performed to treat a relapsing Staphylococcus aureus chronic prosthetic joint infection (PJI). This salvage treatment was safe and associated with a clinical success. Scientific evaluation of the potential clinical benefit of bacteriophages as antibiofilm treatment in PJI is now feasible and... Read more »
Relevance of Modified Debridement-Irrigation, Antibiotic Therapy and Implant Retention Protocol for the Management of Surgical Site Infections: A Series of 1694 Instrumented Spinal Surgery.
J Bone Jt Infect. 2018 Dec 24;3(5):266-272. doi: 10.7150/jbji.28765. eCollection 2018.
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Introduction Management of surgical site infections (SSI) after instrumented spinal surgery remains controversial. The debridement-irrigation, antibiotic therapy and implant retention protocol (DAIR protocol) is safe and effective to treat deep SSI occurring within the 3 months after instrumented spinal surgery. Methods This retrospective study describes the outcomes of patients treated over a period of 42... Read more »

2017

Intraosteoblastic activity of daptomycin in combination with oxacillin and ceftaroline against MSSA and MRSA
J Antimicrob Chemother. 2017 Dec 1;72(12):3353-3356. doi: 10.1093/jac/dkx314.
international
Background: The Staphylococcus aureus intracellular reservoir is associated with bone and joint infection (BJI) chronicity. As daptomycin is increasingly prescribed in BJI, strategies for improving its reduced intracellular activity should be promoted. Objectives: Based on the known in vitro synergy of daptomycin with β-lactams, the aim of the present study was to evaluate the intracellular... Read more »
Clinical metagenomics of bone and joint infections: a proof of concept study
Sci Rep. 2017 Aug 10;7(1):7718. doi: 10.1038/s41598-017-07546-5.
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Bone and joint infections (BJI) are severe infections that require a tailored and protracted antibiotic treatment. Yet, the diagnostic based on culturing samples lacks sensitivity, especially for hardly culturable bacteria. Metagenomic sequencing could potentially address those limitations. Here, we assessed the performances of metagenomic sequencing on 24 BJI samples for the identification of pathogens and... Read more »
The not-so-good prognosis of streptococcal periprosthetic joint infection managed by implant retention: the results of a large multicenter study
Clin Infect Dis. 2017 Jun 15;64(12):1742-1752. doi: 10.1093/cid/cix227.
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Background: Streptococci are not an infrequent cause of periprosthetic joint infection (PJI). Management by debridement, antibiotics, and implant retention (DAIR) is thought to produce a good prognosis, but little is known about the real likelihood of success. Methods: A retrospective, observational, multicenter, international study was performed during 2003–2012. Eligible patients had a streptococcal PJI that... Read more »
Prolonged suppressive antibiotic therapy for prosthetic joint infection in the elderly: a national multicentre cohort study
Eur J Clin Microbiol Infect Dis. 2017 Sep;36(9):1577-1585. doi: 10.1007/s10096-017-2971-2. Epub 2017 Apr 4.
international
During prosthetic joint infection (PJI), optimal surgical management with exchange of the device is sometimes impossible, especially in the elderly population. Thus, prolonged suppressive antibiotic therapy (PSAT) is the only option to prevent acute sepsis, but little is known about this strategy. We aimed to describe the characteristics, outcome and tolerance of PSAT in elderly... Read more »

2016

Diagnostic des infections ostéo-articulaires
Revue Francophone des laboratoires – N° 480 - Mars 2016. Doi : 10.1016/S1773-035X(16)30087-9
international
Le diagnostic microbiologique des infections ostéo-articulaires est complexe et nécessite une collaboration forte entre orthopédistes, infectiologues et biologistes. Il est obligatoire de réaliser des prélèvements dans les conditions les plus strictes d’asepsie au bloc chirurgical avec un acheminement rapide au laboratoire de bactériologie. La multiplication des prélèvements facilite l’interprétation des résultats. Une fois au laboratoire,... Read more »
Methicillin-susceptible strains responsible for postoperative orthopedic infection are not selected by the use of cefazolin in prophylaxis
Diagn Microbiol Infect Dis. 2016 Mar;84(3):266-7. doi: 10.1016/j.diagmicrobio.2015.11.013. Epub 2015 Nov 17.
international
Comparison of methicillin-susceptible Staphylococcus aureus (MSSA) isolates responsible for bone and joint infection (BJI, n=73) and nasal colonization (n=57) revealed similar prevalence of β-lactamase (blaZ) type A production, associated with cefazolin hydrolysis, suggesting that blaZ type A-carrying MSSA isolates implicated in postoperative BJI are not selected by cefazolin prophylaxis
Adaptive processes of Staphylococcus aureus isolates during the progression from acute to chronic bone and joint infections in patients
Cell Microbiol. 2016 Oct;18(10):1405-14. doi: 10.1111/cmi.12582. Epub 2016 Apr 1.
international
Staphylococcus aureus bone and joint infection (BJI) is associated with significant rates of chronicity and relapse. In this study, we investigated how S. aureus is able to adapt to the human environment by comparing isolates from single patients with persisting or relapsing BJIs that were recovered during the initial and recurrent BJI episodes. In vitro... Read more »
Pristinamycin in the treatment of MSSA bone and joint infection
J Antimicrob Chemother. 2016 Apr;71(4):1063-70. doi: 10.1093/jac/dkv457. Epub 2016 Jan 21.
international
OBJECTIVES: The aim of this study was to evaluate pristinamycin in the treatment of MSSA bone and joint infection (BJI). PATIENTS AND METHODS: A retrospective, single-centre cohort study (2001-11) investigated outcome in adults receiving pristinamycin for MSSA BJI and pristinamycin-related adverse events (AEs). RESULTS: One hundred and two MSSA BJIs were assessed in 98 patients... Read more »
Teicoplanin-based antimicrobial therapy in Staphylococcus aureus bone and joint infection: tolerance, efficacy and experience with subcutaneous administration
BMC Infect Dis . 2016 Nov 3;16(1):622. doi: 10.1186/s12879-016-1955-7.
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BACKGROUND: Staphylococci represent the first etiologic agents of bone and joint infection (BJI), leading glycopeptides use, especially in case of methicillin-resistance or betalactam intolerance. Teicoplanin may represent an alternative to vancomycin because of its acceptable bone penetration and possible subcutaneous administration. METHODS: Adults receiving teicoplanin for S. aureus BJI were included in a retrospective cohort... Read more »
Daptomycin > 6 mg/kg/day as salvage therapy in patients with complex bone and joint infection: cohort study in a regional reference center
BMC Infect Dis. 2016 Feb 17;16:83. doi: 10.1186/s12879-016-1420-7.
free access international
BACKGROUND: Even if daptomycin does not have approval for the treatment of bone and joint infections (BJI), the Infectious Diseases Society of America guidelines propose this antibiotic as alternative therapy for prosthetic joint infection. The recommended dose is 6 mg/kg/d, whereas recent data support the use of higher doses in these patients. METHODS: We performed... Read more »
Pharmacokinetic Variability of Daptomycin during Prolonged Therapy for Bone and Joint Infections
Antimicrob Agents Chemother. 2016 Apr 22;60(5):3148-51. doi: 10.1128/AAC.02597-15. Print 2016 May.
free access international
The interindividual and intraindividual variabilities in daptomycin pharmacokinetics were investigated in 23 patients (69 pharmacokinetic profiles) who were treated for several months for bone and joint infections. Population daptomycin clearance was significantly influenced by renal function and was significantly higher in male than in female patients. We observed significant intraindividual changes in daptomycin clearance, which... Read more »
Pathophysiological Mechanisms of Staphylococcus Non-aureus Bone and Joint Infection: Interspecies Homogeneity and Specific Behavior of S. pseudintermedius
Front Microbiol. 2016 Jul 12;7:1063. doi: 10.3389/fmicb.2016.01063. eCollection 2016.
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Implicated in more than 60% of bone and joint infections (BJIs), Staphylococci have a particular tropism for osteoarticular tissue and lead to difficult-to-treat clinical infections. To date, Staphylococcus aureus internalization in non-professional phagocytic cells (NPPCs) is a well-explored virulence mechanism involved in BJI chronicity. Conversely, the pathophysiological pathways associated with Staphylococcus non-aureus (SNA) BJIs have... Read more »
Rapid bench identification of methicillin-sensitive and methicillin-resistant Staphylococcus aureus: A multicenter comparative evaluation of Alere PBP2a Culture Colony Test (Alere) Versus Slidex MRSA detection (bioMérieux)
Diagn Microbiol Infect Dis. 2016 Aug;85(4):419-21. doi: 10.1016/j.diagmicrobio.2016.04.008. Epub 2016 Apr 12.
international
Using 30 clinical isolates of Staphylococcus aureus representative of the most prevalent clones circulating in France, the performance of the Alere™ PBP2a Culture Colony Test (CCT) and the Slidex® MRSA detection kit (SMD) were compared in 5 different labs. CCT demonstrated better performance and was easier to conduct in routine.
Preliminary results of a new antibiotic susceptibility test against biofilm installation in device-associated infections: the Antibiofilmogram®
Pathog Dis. 2016 Aug;74(6). pii: ftw057. doi: 10.1093/femspd/ftw057. Epub 2016 Jun 16.
international
Biofilms are complex communities of microorganisms embedded in an extracellular matrix and adherent to a surface. The development was described as a four-stage process leading to the formation of a mature biofilm which was resistant to immune system and antibiotic actions. In bone and joint infections (BJIs), the formation of biofilms is a leading cause... Read more »

2015

Antimicrobial activity against intraosteoblastic Staphylococcus aureus
Antimicrob Agents Chemother. 2015 Apr;59(4):2029-36. doi: 10.1128/AAC.04359-14. Epub 2015 Jan 20.
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Although Staphylococcus aureus persistence in osteoblasts, partly as small-colony variants (SCVs), can contribute to bone and joint infection (BJI) relapses, the intracellular activity of antimicrobials is not currently considered in the choice of treatment strategies for BJI. Here, antistaphylococcal antimicrobials were evaluated for their intraosteoblastic activity and their impact on the intracellular emergence of SCVs... Read more »
Delta-toxin production deficiency in Staphylococcus aureus: a diagnostic marker of bone and joint infection chronicity linked with osteoblast invasion and biofilm formation
Clin Microbiol Infect. 2015 Jun;21(6):568.e1-11. doi: 10.1016/j.cmi.2015.01.026. Epub 2015 Feb 10.
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Biofilm formation, intra-osteoblastic persistence, small-colony variants (SCVs) and the dysregulation of agr, the major virulence regulon, are possibly involved in staphylococcal bone and joint infection (BJI) pathogenesis. We aimed to investigate the contributions of these mechanisms among a collection of 95 Staphylococcus aureus clinical isolates from 64 acute (67.4%) and 31 chronic (32.6%) first episodes of BJI.... Read more »
Methicillin-susceptible strains responsible for postoperative orthopedic infection are not selected by the use of cefazolin in prophylaxis
Diagn Microbiol Infect Dis. 2016 Mar;84(3):266-7. doi: 10.1016/j.diagmicrobio.2015.11.013. Epub 2015 Nov 17.
international
Comparison of methicillin-susceptible Staphylococcus aureus (MSSA) isolates responsible for bone and joint infection (BJI, n=73) and nasal colonization (n=57) revealed similar prevalence of β-lactamase (blaZ) type A production, associated with cefazolin hydrolysis, suggesting that blaZ type A-carrying MSSA isolates implicated in postoperative BJI are not selected by cefazolin prophylaxis
Dual impact of live Staphylococcus aureus on the osteoclast lineage, leading to increased bone resorption
J Infect Dis. 2015 Feb 15;211(4):571-81. doi: 10.1093/infdis/jiu386. Epub 2014 Jul 8.
international
BACKGROUND: Bone and joint infection, mainly caused by Staphylococcus aureus, is associated with significant morbidity and mortality, characterized by severe inflammation and progressive bone destruction. Studies mostly focused on the interaction between S. aureus and osteoblasts, the bone matrix-forming cells, while interactions between S. aureus and osteoclasts, the only cells known to be able to degrade bone, have been poorly... Read more »

2014

Management strategies of prosthetic joint infections of the hip
Minerva Ortopedica e Traumatologica 2014 June;65(3):243-9
international
Prosthetic joint infection (PJI) of the hip remains a devastating and costly complication of total hip arthroplasty. The treatment depends on many factors: host comorbidities, the duration of symptoms and the infecting organism. Irrigation and debridement can be performed for acute cases accompanied by modular component exchange. For chronic infections, a single-stage or two-stage revision... Read more »
Rapid detection of Staphylococcus aureus and methicillin resistance in bone and joint infection samples: evaluation of the GeneXpert MRSA/SA SSTI assay
Diagn Microbiol Infect Dis . 2014 Mar;78(3):313-5. doi: 10.1016/j.diagmicrobio.2013.11.026. Epub 2013 Dec 6.
international
The GeneXpert MRSA/SA SSTI assay was compared to conventional cultures to detect Staphylococcus aureus and methicillin-resistance from 91 bone and joint infection samples. Sensitivity and specificity were 94.4% and 100%. Three false-positive results were observed, in fact providing from patients known to be infected by S. aureus on the basis of other concomitant osteoarticular samples,... Read more »
Determinants of methicillin-susceptible Staphylococcus aureus native bone and joint infection treatment failure: a retrospective cohort study.
BMC Infect Dis . 2014 Aug 16;14:443. doi: 10.1186/1471-2334-14-443.
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Background: Although methicillin-susceptible Staphylococcus aureus (MSSA) native bone and joint infection (BJI) constitutes the more frequent clinical entity of BJI, prognostic studies mostly focused on methicillin-resistant S. aureus prosthetic joint infection. We aimed to assess the determinants of native MSSA BJI outcomes. Methods: Retrospective cohort study (2001-2011) of patients admitted in a reference hospital centre... Read more »
Staphylococcus aureus-Related Diabetic Osteomyelitis: Medical or Surgical Management? A French and Spanish Retrospective Cohort
Int J Low Extrem Wounds . 2015 Sep;14(3):284-90.
international
Staphylococcus aureus is the main cause of diabetic foot osteomyelitis (DFO) and can be treated medically or by surgery. We investigated the outcome of consecutive patients with a diagnosis of S aureus DFO retrospectively in 4 hospitals according to the type of management, medical (including debridement at bedside) or surgical. The outcome was classified as... Read more »
Antimicrobial-related Severe Adverse Events During Treatment of Bone and Joint Infection Due to Methicillin-Susceptible Staphylococcus Aureus
Antimicrob Agents Chemother . 2014;58(2):746-55. doi: 10.1128/AAC.02032-13. Epub 2013 Nov 18.
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Prolonged antimicrobial therapy is recommended for methicillin-susceptible Staphylococcus aureus (MSSA) bone and joint infections (BJI), but its safety profile and risk factors for severe adverse events (SAE) in clinical practice are unknown. We addressed these issues in a retrospective cohort study (2001 to 2011) analyzing antimicrobial-related SAE (defined according to the Common Terminology Criteria for... Read more »
Methicillin-susceptible Staphylococcus Aureus Clonal Complex 398: High Prevalence and Geographical Heterogeneity in Bone and Joint Infection and Nasal Carriage
Clin Microbiol Infect . 2014 Oct;20(10):O772-5. doi: 10.1111/1469-0691.12567. Epub 2014 Mar 6.
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The prevalence of clonal complex (CC) 398 methicillin-susceptible Staphylococcus aureus (MSSA) was unexpectedly high among bone and joint infections (BJIs) and nasal-colonizing isolates in France, with surprising geographical heterogeneity. With none of the major, most-known staphylococcal virulence genes, MSSA CC398 BJI was associated with lower biological inflammatory syndrome and lower treatment failure rates.
Activation of NK cells in patients with chronic bone and joint infection due to staphylococci expressing or Not the small colony variant phenotype.
Int J Chronic Dis. 2014;2014:280653. doi: 10.1155/2014/280653. Epub 2014 Mar 3.
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Chronic bone and joint infections (BJI) are devastating diseases. Relapses are frequently observed, as some pathogens, especially staphylococci, can persist intracellularly by expressing a particular phenotype called small colony variant (SCV). As natural killer (NK) cells are lymphocytes specialized in the killing of host cells infected by intracellular pathogens, we studied NK cells of patients... Read more »
Actinomycosis : etiology, clinical features, diagnosis, treatment and management
Infect Drug Resist . 2014 Jul 5;7:183-97. doi: 10.2147/IDR.S39601. eCollection 2014.
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Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. Physicians must be aware of typical clinical presentations (such as cervicofacial actinomycosis following dental focus of infection, pelvic actinomycosis in women with an intrauterine device, and pulmonary actinomycosis in smokers with... Read more »
Risk factors, diagnosis and management of bone flap osteomyelitis following craniectomy
Journal des Anti-Infectieux - Volume 16, n° 4 - pages 166-174 (décembre 2014)
international
L’ostéite du volet crânien après craniectomie (OVCc) est une infection ostéoarticulaire (IOA) méconnue et il existe peu de données concernant son épidémiologie, ses facteurs de risque, et sa prise en charge. Dans cet article de synthèse, nous reprenons les principales données de la littérature et proposons une stratégie médico-chirurgicale pour la prise en charge des... Read more »