![\"\"](\"https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/differentes-voies-inoculation-1024x576.jpg\")
\nAnother route of entry is direct<\/strong> inoculation, for example in the aftermath of a fracture or an open wound or after revision of a knee prosthesis. BJIs are often “post-operatory”<\/strong> infections. The risk is even greater when the patient is elderly, frail, a smoker, and has already had multiple operations. With a combination of these risk factors, the post-operative infection rate can be more than 50%.<\/strong> BJI can also be caused through a contiguous route<\/strong>, that is to say, a nearby infection can gradually contaminate bone tissue or a prosthesis. BJI can be the result of : (i) a deep and persistant skin wound, common in paraplegic patients, who have bedsores due to prolonged pressure on the skin; or (ii) a contagious skin infection such as dermo-hypodermitis or erysipelas, which can spread to a knee prosthesis.<\/p>\n <\/p>\n <\/p>\n These infections are heterogeneous<\/strong> because any bone or joint can be affected, any bacteria<\/strong> and any route (haematogenous<\/strong>, contiguous<\/strong> or post-operative<\/strong>) can be involved. Since treatment is most often surgical or medical, the evaluation of antibiotic treatment and different strategies is complex.\u00a0<\/span><\/p>\n The direct and indirect cost of prosthesis infections is considerable<\/strong>, and greatly underestimated. The personal cost to the patient is significant due to resulting physical disability and prolonged sick-leave and hospitalisation. The social cost is also significant: for example, a BJI can cost the French public health care system 50 000 euros when superinfection occurs during a prosthesis change. Current knowledge is mainly based on experience and observation, and there are few clinical trials in the field<\/strong> of BJI<\/strong><\/a>. As a result, there are few antibiotics approved<\/strong> for this indication. Compared to rarer infections such as meningitis, or ones such as urinary tract infections, therapeutic trials are rare<\/strong> in the field of BJI<\/strong><\/a>. Thus, BJIs can be considered as one of the “neglected infectious diseases” of industrialised countries<\/strong>.<\/p>\n A bone and joint infection (BJI) can be caused by one or several micro-organisms, most often bacteria. There are different routes of entry. These bacteria can reach, for example, a knee prosthesis through the blood stream (haematogenous route), which can happen in the case of septicaemia, when bacteria pass into the blood from a urinary or dental infection. Another route<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-3633","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/pages\/3633","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/comments?post=3633"}],"version-history":[{"count":22,"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/pages\/3633\/revisions"}],"predecessor-version":[{"id":5568,"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/pages\/3633\/revisions\/5568"}],"wp:attachment":[{"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/media?parent=3633"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/aio-generalites-francais-1024x709.jpeg\")
\n![\"\"](\"https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/ioa-clinicaltrials-1024x709.jpeg\")
<\/p>","protected":false},"excerpt":{"rendered":"