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12. 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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13. 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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16. 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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22. 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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27. 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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36. 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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38. 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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45. The Sinus Tract in Bone and Joint Infection: Minimally Invasive Salvation or Prolonged Suffering? A Multicenter Study

Author

Klim, Sebastian Martin, primary, Amerstorfer, Florian, additional, McNally, Martin A., additional, Trebse, Rihard, additional, Slokar, Urban, additional, Sigmund, Irene Katharina, additional, Hecker, Andrzej, additional, Reinbacher, Patrick, additional, Leitner, Lukas, additional, Bernhardt, Gerwin Alexander, additional, Leithner, Andreas, additional, Wanko, Sophie, additional, and Glehr, Mathias, additional

Published
2023
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46. Diagnosis of fracture-related infection in patients without clinical confirmatory criteria: an international retrospective cohort study

Author

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

Published
2023
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50. Diagnosis of fracture-related infection in patients without clinical confirmatory criteria:an international retrospective cohort study

Author

Vanvelk, Niels, Van Lieshout, Esther M.M., Onsea, Jolien, Sliepen, Jonathan, Govaert, Geertje, Ijpma, Frank F.A., Depypere, Melissa, Ferguson, Jamie, Mcnally, Martin, Obremskey, William T., Zalavras, Charalampos, Verhofstad, Michael H.J., Metsemakers, Willem Jan, Vanvelk, Niels, Van Lieshout, Esther M.M., Onsea, Jolien, Sliepen, Jonathan, Govaert, Geertje, Ijpma, Frank F.A., Depypere, Melissa, Ferguson, Jamie, Mcnally, Martin, Obremskey, William T., Zalavras, Charalampos, Verhofstad, Michael H.J., and Metsemakers, Willem Jan

Abstract

Background: fracture-related infection (FRI) remains a serious complication in orthopedic trauma. To standardize daily clinical practice, a consensus definition was established, based on confirmatory and suggestive criteria. In the presence of clinical confirmatory criteria, the diagnosis of an FRI is evident, and treatment can be started. However, if these criteria are absent, the decision to surgically collect deep tissue cultures can only be based on suggestive criteria. The primary study aim was to characterize the subpopulation of FRI patients presenting without clinical confirmatory criteria (fistula, sinus, wound breakdown, purulent wound drainage or presence of pus during surgery). The secondary aims were to describe the prevalence of the diagnostic criteria for FRI and present the microbiological characteristics, both for the entire FRI population. Methods: a multicenter, retrospective cohort study was performed, reporting the demographic, clinical and microbiological characteristics of 609 patients (with 613 fractures) who were treated for FRI based on the recommendations of a multidisciplinary team. Patients were divided in three groups, including the total population and two subgroups of patients presenting with or without clinical confirmatory criteria. Results: clinical and microbiological confirmatory criteria were present in 77g and 87g of the included fractures, respectively. Of patients, 23g presented without clinical confirmatory criteria, and they mostly displayed one (31g) or two (23g) suggestive clinical criteria (redness, swelling, warmth, pain, fever, new-onset joint effusion, persisting/increasing/new-onset wound drainage). The prevalence of any suggestive clinical, radiological or laboratory criteria in this subgroup was 85g, 55g and 97g, respectively. Most infections were monomicrobial (64g) and caused by Staphylococcus aureus. Conclusion: clinical confirmatory criteria were absent in 23g of the FRIs. In these cases, the decision to ope

Published
2023

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