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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 59 - 59
1 Dec 2019
Giannitsioti E Salles M Mavrogenis A Rodríguez-Pardo D Pigrau C Ribera A Ariza J Toro DD Nguyen S Senneville E Bonnet E Chan M Pasticci MB Petersdorf S Soriano A Benito N Connell NO García AB Skaliczki G Tattevin P Tufan ZK Pantazis N Megaloikonomos PD Papagelopoulos P Papadopoulos A
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Aim

Gram negative bacteria (GNB) are emerging pathogens in chronic post-traumatic osteomyelitis. However, data on multi-drug (MDR) and extensively drug resistant (XDR) GNB are sparse.

Methods

A multi-centre epidemiological study was performed in 10 countries by members of the ESGIAI (ESCMID Study Group on Implant Associated Infections). Osteosynthesis-associated osteomyelitis (OAO) of the lower extremities and MDR/XDR GNB were defined according to international guidelines. Data from 2000 to 2015 on demographics, clinical features, microbiology, surgical treatment and antimicrobial therapy were retrospectively analyzed. Cure was assessed after the end of treatment as the absence of any sign relevant to OAO. Factors associated with cure were evaluated by regression analysis.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 91 - 91
1 Dec 2018
Papadopoulos A Ribera A Mavrogenis A Rodríguez-Pardo D Bonnet E Salles M del Toro MD Nguyen S García AB Skaliczki G Soriano A Benito N Petersdorf S Pasticci MB Tattevin P Tufan ZK Chan M Connell NO Pantazis N Pigrau C Megaloikonomos PD Senneville E Ariza J Papagelopoulos P Giannitsioti E
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Aim

Data on Prosthetic joint infection (PJI) caused by multi-drug resistant (MDR) or XDR (extensively drug resistant) Gram negative bacteria (GNB) are limited. Treatment options are also restricted. We conducted a multi-national, multi-center assessment of clinical data and factors of outcome for these infections.

Method

PJI were defined upon international guidelines. Data from 2000–2015 on demographics, clinical features, microbiology, surgical treatment and antimicrobial therapy was collected retrospectively. Factors associated with treatment success were evaluated by logistic regression analysis.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_16 | Pages 83 - 83
1 Dec 2015
Papadopoulos A Karatzios K Malizos K Varitimidis S
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Report of a case of migrating periprosthetic infection from a hip replacement to a contralateral knee joint undergoing a total knee replacement.

We present a 74-year old female patient who underwent a total hip arthroplasty of the left hip after a subcapital fracture of the femur. Four months after the index procedure the patient presented with signs and symptoms of infection of the operated joint. Staph aureus and Enterococcus faecalis were recognized as the infecting bacteria. The implants were removed, cement spacers were placed and a total hip arthroplasty was performed again after three months. Unfortunately, infection ensued again and the patient underwent three more procedures until the joint was considered clean and t he hip remained flail without implants. The patient elected to undergo a total knee arthroplasty due to severe osteoarthritis of right knee. Intraoperatively tissue samples were taken and sent for cultures which identified Enterococcus faecalis present in the knee joint. Enterococcus migrated from the infected hip to nonoperated knee joint. Intravenous antibiotics were administered for three weeks but the knee presented with infection of the arthroplasty ten months after its insertion. The implants were removed the joint was debrided and cement spacers were inserted.

The patient decided not to proceed with another procedure and she remains with the cement spacers in her knee.

Rare report of migrating periprosthetic infection. Nosocomial enterococci acquired resistance cannot be ruled out. Unique characteristics in enterococci antibiotic resistance and biofilm formation.