Antibiotic resistance represents a threat to human health. It has been suggested that by 2050, antibiotic-resistant infections could cause ten million deaths each year. In orthopaedics, many patients undergoing surgery suffer from complications resulting from implant-associated infection. In these circumstances secondary surgery is usually required and chronic and/or relapsing disease may ensue. The development of effective treatments for antibiotic-resistant infections is needed. Recent evidence shows that bacteriophage (phages; viruses that infect bacteria) therapy may represent a viable and successful solution. In this review, a brief description of bone and joint infection and the nature of bacteriophages is presented, as well as a summary of our current knowledge on the use of bacteriophages in the treatment of bacterial infections. We present contemporary published in vitro and in vivo data as well as data from clinical trials, as they relate to bone and joint infections. We discuss the potential use of bacteriophage therapy in orthopaedic infections. This area of research is beginning to reveal successful results, but mostly in nonorthopaedic fields. We believe that bacteriophage therapy has potential therapeutic value for implant-associated infections in orthopaedics. Cite this article:
The diagnosis of periprosthetic joint infection can be difficult
due to the high rate of culture-negative infections. The aim of
this study was to assess the use of next-generation sequencing for
detecting organisms in synovial fluid. In this prospective, single-blinded study, 86 anonymized samples
of synovial fluid were obtained from patients undergoing aspiration
of the hip or knee as part of the investigation of a periprosthetic
infection. A panel of synovial fluid tests, including levels of
C-reactive protein, human neutrophil elastase, total neutrophil
count, alpha-defensin, and culture were performed prior to next-generation
sequencing.Aims
Materials and Methods
