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17. A Comparison of Causative Pathogens in Bone and Prosthetic Joint Infections: Implications for Antimicrobial Therapy †.

Author

Unsworth, Annalise, Young, Bernadette, Scarborough, Matthew, and McNally, Martin

Subjects
PROSTHESIS-related infections, JOINT infections, MICROBIAL cultures, VANCOMYCIN resistance, STAPHYLOCOCCUS aureus
Abstract

Background: The microbiological profile of bone and joint infections is important for determining the empiric choice of both systemic and local antimicrobial therapy. This study assessed whether there was a difference in the bacterial species that were isolated on culture in osteomyelitis (OM), fracture-related infection (FRI) or prosthetic joint infection (PJI). This was a retrospective, observational cohort study of patients who had surgical intervention for PJI or OM or FRI with a positive microbial culture between 2019 and 2022. Methods: Data including patient demographics, the site of injury, JS-BACH score, organism classification and antibiotic resistance to vancomycin and gentamicin were extracted from the medical records. Results: A total of 440 patients were included in this study: 163 patients with osteomyelitis, 109 with fracture-related infection with fixation implants and 168 with prosthetic joint infection. The patients with PJI were older, more likely to be female and had a higher BMI and ASA score compared to those with OM. Patients with PJI were more likely to have a higher JS-BACH score and more complex infections. Staphylococcus aureus was the most commonly isolated organism in all three groups. It was more frequently isolated in osteomyelitis than in PJI (p = 0.016). In both osteomyelitis and FRI, after Staphylococcus aureus, the next most common organisms were Gram-negatives, whilst for PJIs, the most commonly isolated organisms were Staphylococcus aureus, followed by coagulase-negative Staphylococci and then Streptococcus species. The rates of other organisms were broadly similar between the three groups. When adjusted for confounders, including symptom duration, JS-BACH score, the location of injury, age and BMI, there was no statistically significant difference in the presence of Staphylococcus aureus (OR = 0.765; 95% CI 0.633–1.232; p = 0.465) or polymicrobial infection (OR = 1.175; 95% CI 0.803–1.721; p = 0.407). Conclusions: Causative pathogens are similar across bone and joint infections and are independent of the presence of prosthetic material. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Infected Nonunions Around the Knee

Author

Ferguson, Jamie, Morgenstern, Mario, Stubbs, David, McNally, Martin, Biberthaler, Peter, Series Editor, Waddell, James P., Series Editor, and Hanschen, Marc, editor

Published
2021
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23. Local Antimicrobial Therapy with Combined Aminoglycoside and Vancomycin Compared to Aminoglycoside Monotherapy in the Surgical Management of Osteomyelitis and Fracture-Related Infection.

Author

Unsworth, Annalise, Young, Bernadette, Ferguson, Jamie, Scarborough, Matthew, and McNally, Martin

Subjects
TREATMENT effectiveness, DISEASE relapse, VANCOMYCIN, MULTIVARIATE analysis, GENTAMICIN
Abstract

We investigated the effect of combination aminoglycoside and vancomycin local antibiotic treatment compared to aminoglycoside alone in the surgical management of bone infection. Data including patient demographics, type of surgery, microbiological characteristics, BACH score, duration of antibiotic treatment and clinical outcomes were collected. Failure of therapy was a composite of recurrence of infection, continued or new antimicrobial therapy, or reoperation with suspected or confirmed infection at one year after index surgery. A total of 266 patients met the inclusion criteria. 252 patients reached the final follow-up and were included in the final analysis. 113 patients had treatment with aminoglycoside alone and 139 patients had combination aminoglycoside and vancomycin. There was no difference in the failure rate between groups; 10/113 (8.8%) in the aminoglycoside alone and 12/139 (8.6%) in the combination group, p = 0.934. Multivariate analysis showed that there was no added benefit of combination therapy (OR 1.54: 95% CI 0.59–4.04, p = 0.38). BACH score and low BMI were associated with increased risk of failure (BACH OR 3.49: 95% CI 1.13–10.76, p = 0.03; Low BMI OR 0.91: 95% CI 0.84–0.99, p = 0.037). The form of the carrier material (pellets or injectable paste) had no effect on failure rate (p = 0.163). The presence of aminoglycoside resistance had no effect on failure rate (OR 0.39: 95% CI 0.05–3.01, p = 0.37). Clinical outcome was not improved by the addition of vancomycin to aminoglycoside alone as local therapy for the management of bone infection. [ABSTRACT FROM AUTHOR]

Published
2024
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25. The Microbiological Profile and Antibiotic Susceptibility of Fracture Related Infections in a Low Resource Setting Differ from High Resource Settings: A Cohort Study from Cameroon

Author

Fonkoue, Loïc, primary, Tissingh, Elizabeth K., additional, Ngouateu, Michelle Tognia, additional, Muluem, Kennedy Olivier, additional, Ngongang, Olivier, additional, Mbouyap, Pretty, additional, Ngougni Pokem, Perrin, additional, Fotsing, Kuetche, additional, Bahebeck, Jean, additional, McNally, Martin, additional, and Cornu, Olivier, additional

Published
2024
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35. PROSTHETIC JOINT INFECTIONS DUE TO CANDIDA SPP.: A MULTICENTRE INTERNATIONAL OBSERVATIONAL STUDY

Author

Dinh, Aurélien, primary, Chatillon, Emma D'anglejan, additional, Ho, Rosemary, additional, McNally, Martin, additional, Dudareva, Maria, additional, Scarborough, Matthew, additional, Jesuthasan, Gerald, additional, Escolà-Vergé, Laura, additional, Lora-Tamayo, Jaime, additional, Mancheño-Losa, Mikel, additional, Thill, Pauline, additional, Giordano, Gérard, additional, Fourcade, Camille, additional, Duran, Clara, additional, Bonnet, Eric, additional, and Hascoet, Julie Lourtet, additional

Published
2023
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40. The global burden of fracture-related infection: can we do better?

Author

Metsemakers, Willem-Jan, primary, Moriarty, T Fintan, additional, Morgenstern, Mario, additional, Marais, Leonard, additional, Onsea, Jolien, additional, O'Toole, Robert V, additional, Depypere, Melissa, additional, Obremskey, William T, additional, Verhofstad, Michael H J, additional, McNally, Martin, additional, Morshed, Saam, additional, Wouthuyzen-Bakker, Marjan, additional, and Zalavras, Charalampos, additional

Published
2023
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43. Musculoskeletal Infection in Orthopaedic Trauma: Assessment of the 2018 International Consensus Meeting on Musculoskeletal Infection

Author

Obremskey, William T., Metsemakers, Willem-Jan, Schlatterer, Daniel R., Tetsworth, Kevin, Egol, Kenneth, Kates, Stephen, McNally, Martin, Gibbons, John, Kenny, Paddy, Obremskey, William T., Stangl, Paul, Patzakis, Michael J., Ferreira, Nando, Tornetta, Paul, III, Suda, Arnold J., O’Hara, Nathan, Costa Salles, Mauro Jose, Bhashyam, Abhiram R., Morgenstern, Mario, Manrique, Jorge, Malizos, Konstantinos N., Giannoudis, Peter, Egol, Kenneth A., Kleftouris, George, Reyes, Francisco, Klement, Mitchell R., Bautista, Maria, Linke, Philip, Citak, Mustafa, Abdelaziz, Hussein, Ecker, Niklas Unter, Suero, Eduardo, Caba, Pedro, Marais, Leonard, Haasper, Carl, Papakostidis, Costas, Natoli, Roman M., Aldahamsheh, Osama, Abuodeh, Yousef, Quinnan, Stephen, Suarez, Cristina, Conway, Janet D., Sánchez Correa, Carlos A., Leal, Jaime A., Zalavras, Charalampos, Komnos, Georgios, Shope, Alexander J., Saxena, Arjun, Fram, Brianna, Åkesson, Per, Haggard, Warren O., Vahedi, Hamed, Athanaselis, Efstratios, Pesantez, Rodrigo, Lowenberg, David W., Gleason, Brendan, Hendershot, Edward F., Amaris, Gerson, Metsemakers, Willem-Jan, Kates, Stephen L., Chang, Gerard, Archdeacon, Michael T., Pinzón, Andrés, Shetty, Rajendra Prasad, Chan, James, McNally, Martin A., Shaffer, Andre, Schlatterer, Daniel R., Harris, Mitchel, Tetsworth, Kevin, Matsushita, Kazuhiko, Kvederas, Giedrius, Garcia, Maria Fernanda, Swiontkowski, Marc F., Kallel, Sofiene, Gutierrez, Vicky, Alt, Volker, O’Toole, Robert V., and Watson, J. Tracy

Published
2020
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49. Corrigendum to: Validation of the diagnostic criteria of the consensus definition of fracture-related infection Injury (2022);53, pages 1867-1879

Author

Onsea, Jolien, primary, Van Lieshout, Esther M.M., additional, Zalavras, Charalampos, additional, Sliepen, Jonathan, additional, Depypere, Melissa, additional, Noppe, Nathalie, additional, Ferguson, Jamie, additional, Verhofstad, Michael H.J., additional, Govaert, Geertje A.M., additional, IJpma, Frank F.A., additional, McNally, Martin A., additional, and Metsemakers, Willem-Jan, additional

Published
2023
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