{"id":4161,"date":"2020-06-05T14:49:44","date_gmt":"2020-06-05T12:49:44","guid":{"rendered":"https:\/\/www.crioac-lyon.fr\/?page_id=4161"},"modified":"2024-01-11T10:52:32","modified_gmt":"2024-01-11T09:52:32","slug":"algorithme-infection-de-prothese","status":"publish","type":"page","link":"https:\/\/www.crioac-lyon.fr\/en\/algorithme-infection-de-prothese\/","title":{"rendered":"Algorithm for the diagnosis of prosthetic joint infection"},"content":{"rendered":"<p><\/p>\n<div class=\"cri-emphasis summary\">The diagnosis of\u00a0<strong>prosthetic joint-associated infections<\/strong> can be difficult, due to the\u00a0<a href=\"https:\/\/www.crioac-lyon.fr\/physiopathologie-infection-de-prothese\/\"><strong>complex pathophysiology of this infection<\/strong><\/a>, and the ways that pathogens, responsible for the infection, can evade detection. Therefore a <strong>&#8220;grey zone&#8221;<\/strong> can exist, when patients, truly presenting with infection, receive negative bacterial culture results. During the 2018 International Consensus Meeting in Philadelphia (ICM Philly), <a href=\"https:\/\/www.crioac-lyon.fr\/documents\/recommandations\/\"><strong>international recommendations<\/strong><\/a>\u00a0were issued for the diagnosis of periprosthetic joint infection. <strong>We use these criteria at CRIOAc Lyon <\/strong>(summerised below)\u00a0<strong>and adapt the care of each patient accordingly.<\/strong><\/div>\n<img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-5182\" src=\"https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/Criteres-philly-crioac-lyon.png\" alt=\"\" width=\"1062\" height=\"754\" srcset=\"https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/Criteres-philly-crioac-lyon.png 1062w, https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/Criteres-philly-crioac-lyon-300x213.png 300w, https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/Criteres-philly-crioac-lyon-1024x727.png 1024w, https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/Criteres-philly-crioac-lyon-768x545.png 768w\" sizes=\"auto, (max-width: 1062px) 100vw, 1062px\" \/>\n<p>&nbsp;<\/p>\n<div class=\"cri-emphasis summary\"><strong>Prosthetic joint infections<\/strong> are complex to manage. <strong>Several algorithms<\/strong>\u00a0are available in the literature and various <a href=\"https:\/\/www.crioac-lyon.fr\/documents\/recommandations\/\"><strong>international recommendations<\/strong><\/a>. <strong>CRIOAc Lyon<\/strong> has developed an algorithm which is based on a clinical approach and which takes into account the <a href=\"https:\/\/www.crioac-lyon.fr\/physiopathologie-infection-de-prothese\/\"><strong>complex pathophysiology of this infection<\/strong><\/a> (highlighted by our <a href=\"https:\/\/www.crioac-lyon.fr\/structuration-de-la-recherche\/\"><strong>research<\/strong><\/a>), and also takes into account the <a href=\"https:\/\/www.crioac-lyon.fr\/documents\/recommandations\/\"><strong>recommendations<\/strong><\/a>. Management is <strong>adapted to each patient, in order to treat the infection, while preserving limb function.<\/strong><\/div>\n<p>&nbsp;<\/p>\n<img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-4433\" src=\"https:\/\/www.crioac-lyon.fr\/wp-content\/uploads\/Algorithme_IOAprothese_01-2024.jpg\" alt=\"\" width=\"960\" height=\"720\" \/>\n<p>&nbsp;<\/p>\n<p>These <strong>different medical-surgical strategies<\/strong> are discussed on a case-by-case basis during <a href=\"https:\/\/www.crioac-lyon.fr\/rcp-du-crioac-lyon\/\"><strong>MDT meetings<\/strong><\/a>. <strong>&#8220;Suppressive&#8221; antibiotic therapy<\/strong> is an oral antibiotic therapy which can be administered, if well-tolerated, for an indefinite duration. It is reserved for patients presenting chronic infection, experiencing only mild functional sequelae, and for patients who <strong>cannot undergo a change of prosthetic due to risk outweighing benefits<\/strong>. In this situation, eradication of the bacteria is not possible, and more often than not, long-term antibiotics can let bacteria persist in a state of dormancy in <a href=\"https:\/\/www.crioac-lyon.fr\/physiopathologie-infection-de-prothese\/\"><strong>biofilm<\/strong><\/a>.<\/p>","protected":false},"excerpt":{"rendered":"<p>The diagnosis of\u00a0prosthetic joint-associated infections can be difficult, due to the\u00a0complex pathophysiology of this infection, and the ways that pathogens, responsible for the infection, can evade detection. Therefore a &#8220;grey zone&#8221; can exist, when patients, truly presenting with infection, receive negative bacterial culture results. During the 2018 International Consensus Meeting in Philadelphia (ICM Philly), international recommendations\u00a0were issued for the diagnosis<\/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-4161","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/pages\/4161","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=4161"}],"version-history":[{"count":22,"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/pages\/4161\/revisions"}],"predecessor-version":[{"id":6301,"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/pages\/4161\/revisions\/6301"}],"wp:attachment":[{"href":"https:\/\/www.crioac-lyon.fr\/en\/wp-json\/wp\/v2\/media?parent=4161"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}