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Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_10 | Pages 71 - 71
1 Oct 2022
MANAGEMENT OF HIP AND KNEE PROSTHESIS JOINT INFECTION (PJI) DUE TO S. AUREUS BY THE “DEBRIDEMENT ANTIBIOTICS AND IMPLANT RETENTION” (DAIR) PROCEDURE IN FRENCH REFERENCE CENTRES (CRIOACS) IN 2019: A RETROSPECTIVE COHORT STUDY
Ferry T Arvieux C Stendel E Nich C Delobel P Zeller V Sotto A Dauchy F RONDE-OUSTAU C Tizon A
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Aim

To describe the management of PJI due to S. aureus in CRIOAcs in 2019 and to particularly focus on the evaluation of the efficacy of DAIR regarding control of infection and risk factors for failure up to 12 months.

Method

Thirteen CRIOAcs were selected to participate to the study. Data concerning the management of all the PJI in the year 2019 were retrospectively collected and registered in eCRFs. Inclusion criteria were: ≥ 18 years old patients with S. aureus ± other bacteria (in per surgical procedure sample); knee or hip PJI and with clinical signs of infection. Patients treated with bacteriophages were excluded. All eligible patients were notified by an information letter. Patients treated by the DAIR procedure were selected, and rate of control of infection (no inflammatory local signs or no new surgical procedure or no S. aureus in case of puncture) was analyzed using Kaplan Meier method and risk factors for failure at 12 months were assessed using Cox regression model.

Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 90 - 90
1 Dec 2018
MOLECULAR TYPING SHOWS THE NEED FOR A NEW DEFINITION OF CUTIBACTERIUM ACNES ORTHOPAEDIC DEVICE-RELATED INFECTIONS
El Sayed F Roux A Bauer T Nich C Sapriel G Dinh A Gaillard J Rottman M
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Aim

Cutibacterium acnes, a skin commensal, is responsible for 5–10% of prosthetic joint infections (PJI). All current microbiological definitions of PJI require two or more identical commensal isolates to be recovered from the same procedure to diagnose PJI and rule out contamination. Unlike coagulase negative staphylococci, C.acnes shows a highly stereotypical susceptibility profile making impossible to phenotypically assess the clonal relationship of isolates. In order to determine the clonal relationship of multiple C.acnes isolates recovered from arthroplasty revisions, we analyzed by multi-locus sequence typing (MLST) C.acnes isolates grown from orthopedic device-related infections (ODRI) in a reference center for bone and joint infection.

Methods

Laboratory records from January 2009 to January 2014 were searched for monomicrobial C.acnes ODRI with growth of C. acnes in at least 2 intraoperative and/or preoperative samples. Clinical, biological and demographic information was collected from hospital charts. All corresponding isolates biobanked in cryovials (−80°C) were subcultured on anaerobic blood agar, and identification confirmed by MALDI-TOF-MS. C.acnes isolates were typed using the MLST scheme described by Lomholt et al. Plasmatic pre-operative C-reactive protein (CRP) levels were determined using DimensionEXL (Siemens). A threshold of 10 mg/L was used to determine serologically positive ODRIs from negatives.

Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 85 - 85
1 Dec 2017
INPUT OF A PHARMACIST IN A REGIONAL REFERRAL CENTRE FOR BONE AND JOINT INFECTIONS
Bouchand F Nich C Petroni G Privé S Truchard E Davido B Hardy P Villart M Dinh A
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Aim

Our hospital is a referral center for Bone and Joint Infection (BJI) with a 15-bed orthopedic unit. Patients benefit from a multidisciplinary team management (surgeons, anesthetists, infectious disease physicians, microbiologists, dietician etc.). Computerized drug prescriptions are performed by anesthetists, surgical residents, surgeons and infectious disease physicians. Since 2015, a pharmacist has been included in ward rounds and in weekly multidisciplinary consultative meetings, where antibiotic treatment strategies are decided for hospitalized patients. This work aimed to assess the impact of a pharmacist in this unit to limit prescription errors.

Method

Prospective monocentric study of all pharmacist's advice or interventions during 15 weeks in 2016 and 2017. A complete pharmaceutical analysis of prescriptions is performed twice a week at least. This analysis is based on doses control and drug interactions, but also takes into account biological and clinical data of patients (patient history, renal function, symptoms, adverse effects…). In case of a prescription error, a computerized message and/or a phone call is sent to the prescriber. Each pharmacist's intervention is recorded and classified according to the French Society of Clinical Pharmacy. The pharmacist collected the number of pharmaceutical advice (when spontaneously solicited by any member of the multidisciplinary team), the different types of prescription errors, the pharmacological class associated to these errors, the types of pharmacist's interventions and their impact on prescriptions.

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