We wonder what the results of two stage procedures were in terms of morbidity (amputation, dead) and infection recurrence. We also seek to identify risk factors for failure and see if the results of a second two stage surgery were not even worse. We retrospectively reviewed 140 prosthetic joint infection (PJI) treated with a two stage procedure. Patient data has been reviewed to determine which factors would be predictive for failure.Aim
Material and Methods
Irrigation is a major step during debridement surgery in the context of Prosthetic Joint Infections (PJI), but its effects on biofilms are poorly described. The present study aims at evaluating the effect of PW alone or followed by antibiotics on MSSA and MRSA biofilms grown on Ti6Al4V coupons in-vitro. Strains: 1 reference (MSSA: ATCC25923; MRSA: ATCC33591) and 2 clinical MSSA and MRSA isolated from PJI. Biofilm culture: Coupons were incubated for 24h at 37°C with bacteria (starting inoculum ∼6.6Log10CFU/mL in TGN [TSB + 1% glucose + 2% NaCl]), under shaking at 50rpm. Treatment: Half of the coupons were irrigated with 50mL physiological serum from 5cm using a Stryker Interpulse; the coupons were then either analysed (ControlT0 and PWT0) or reincubated for 24h in TGN or TGN containing flucloxacillin (MSSA) or vancomycin (MRSA) at MIC or 20mg/L. Analysis: Coupons were rinsed twice with PBS. Biomass was measured by crystal violet (CV) assay. CFUs were counted after recovering bacteria from coupons using sonication and TSA plating.Aim
Method
Bacterial identification in musculoskeletal infection is sometimes difficult and treatment strategy difficult facing unknown pathogen agent. We wonder if the delay of incubation and the preservation conditions of the samples between surgical procurement and subculture on plates have an influence. 25 cm³ bone fragments were obtained from femoral heads retrieved during hip arthroplasty and excluded for bone transplant donation. Informed consent was obtained from the donor for research purpose. The study was approved by the Ethic Committee (N°B403201317725). Bone fragments were immersed for 30 minutes under gently agitation (140 RPM) at 35°C in a physiologic solution (negative control) or two solutions with two concentrations of staphylococcus epidermidis (0.5 Mc Farland or 1.5× 108 bacteria and 7.5×102 bacteria). Bone samples were separated and preserved at room temperature or at 4°C until seeded on Petri Plates to observe the influence of preservation conditions. Samples were plated after different delays (T0, T30min, T1H, T2H, T4H, T6H, T8H, T12H, T16H, T24H et T48H) to observe the influence of delay of culture. Experiments were repeated 5 times. When culture was positive, results were expressed with the number of colony.Aim
Method
