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Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_10 | Pages 4 - 4
1 Oct 2022
MULTICENTRE EVALUATION OF RAPID MOLECULAR SYNDROMIC APPROACH IN JOINT INFECTIONS USING A NEW DEDICATED PANEL: PRELIMINARY RESULTS
Dupieux C Dubois A Loiez C Marchandin H Lavigne JP Munier C Chanard E Gazzano V Courboulès C Roux A Tessier E Corvec S Bemer P Laurent F Roussel-Gaillard T
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Aim

Bone and joint infections (BJIs) are serious infections requiring early optimized antimicrobial therapy. BJIs can be polymicrobial or caused by fastidious bacteria, and the patient may have received antibiotics prior to sampling, which may decrease the sensitivity of culture-based diagnosis. Furthermore, culture-based diagnosis can take up to 14 days. Molecular approaches can be useful to overcome these concerns. The BioFire® system performs syndromic multiplex PCR in 1 hour, with only a few minutes of sample preparation. The BioFire® Joint Infection (JI) panel (BF-JI), recently FDA-cleared, detects both Gram-positive (n=15) and Gram-negative bacteria (n=14), Candida, and eight antibiotic resistance genes directly from synovial fluids. The aim of this study was to evaluate its performance in acute JIs in real-life conditions.

Method

BF-JI was performed on synovial fluid from patients with clinical suspicion of acute JI, either septic arthritis or periprosthetic JI, in 6 French centers. The results of BF-JI were compared with the results of culture of synovial fluid and other concomitantly collected osteoarticular samples obtained in routine testing in the clinical microbiology laboratory.

Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 9 - 9
1 Dec 2019
MANAGEMENT OF EARLY PERIPROSTHETIC JOINT INFECTION WITH DEBRIDEMENT-IRRIGATION, ANTIBIOTIC THERAPY AND IMPLANT RETENTION: POSTOPERATIVE POSITIVE SUCTION DRAINAGE FLUID CULTURE IS A PREDICTIVE FACTOR OF FAILURE
Villain B Thes A Roux A Begue T Bauer T
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Introduction

Success rate after Debridement-Irrigation, Antibiotic Therapy and Implant Retention (DAIR) for treatment of Acute Haematogenous (AH) and Early Post-surgical (EP) periprosthetic joint infection (PJI) varies widely among published studies. Prosthesis exchange is recommended to treat PJI after a failed DAIR. However, no early postoperative prognostic factors permitting to identify future failures have been described.

Aim

Identify early prognostic factor of failure after DAIR in order to propose efficient treatment before onset of chronic PJI.

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 77 - 77
1 Dec 2017
CLONAL RELATIONSHIP OF PROPIONIBACTERIUM ACNES ISOLATES RECOVERED FROM BONE AND JOINT INFECTIONS: DOES MICROBIOLOGICAL DEFINITION OF PROSTHESIS JOINT INFECTIONS APPLY TO THIS MICROORGANISM?
El Sayed F Roux A Rabès J Mazancourt P Bauer T Gaillard J Rottman M
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Aim

Propionibacterium acnes is a skin commensal colonizing the deeper structures of the pilous bulb. It is responsible for 5–10% of lower limb prosthetic joint infections (PJI) but accounts for as many as 50% of shoulder arthroplasty infections. P. acnes PJIs characteristically feature limited systemic inflammation, limited polymorphonuclear infiltration and clinical signs compatible with aseptic loosening. All current microbiological definitions of PJI require two or more identical commensal isolates to be recovered from the same procedure to diagnose PJI to increase specificity and rule out contamination. Whereas the antimicrobial susceptibility patterns of coagulase negative staphylococci are highly polymorphic and commonly allow the ready distinction of unrelated strains, P. acnes shows a highly stereotypical susceptibility profile and it is impossible to phenotypically assess the clonal relationship of isolates. In order to determine the clonal relationship of multiple P. acnes isolates recovered from arthroplasty revisions, we analyzed by multi-locus sequence typing (MLST) P. acnes isolates grown from PJI in a reference center for bone and joint infection.

Method

We retrospectively selected all cases of microbiologically documented monomicrobial PJI caused by P. acnes diagnosed in our center from January 2009 to January 2014. Microorganisms were identified by MALDI-TOF mass spectrometry (Bruker Daltonics). All corresponding P.acnes isolates biobanked in cryovials frozen at −80°C were subcultured on anaerobic blood agar, DNA extracted by freeze-thawing and bead-milling, and typed according to the 9 gene MLST scheme proposed by Lomholt HB. and al.

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