Rifampicin combination therapy versus targeted antimicrobial monotherapy in the oral antimicrobial treatment phase of staphylococcal prosthetic joint infection (RiCOTTA-trial): protocol for a randomized, controlled, open-label, non-inferiority trial.

Background: Rifampicin-combination therapy is currently the first-choice oral antimicrobial regimen for staphylococcal prosthetic joint infections (sPJI) treated by debridement, antibiotics and implant retention (DAIR). Lack of high quality evidence to substantiate this recommendation and a high drug discontinuation rate of this regimen warrant investigation of alternative antimicrobial strategies.

Method: The Rifampicin Combination Therapy versus Targeted Antimicrobial Monotherapy in the Oral Antimicrobial Treatment Phase of Staphylococcal Prosthetic Joint Infection (RiCOTTA)-trial is a multicenter, non-inferiority, open-label, randomized controlled trial evaluating monotherapy (without rifampicin) versus rifampicin-combination therapy in the oral treatment phase of sPJI managed with DAIR.

Periprosthetic Joint Infection Surrounding Lower-Extremity Endoprostheses After Tumor Resection: Causative Microorganisms, Effectiveness of DAIR, and Risk Factors for Treatment Failure.

Background: Periprosthetic joint infection (PJI) surrounding an endoprosthesis after reconstruction of a lower extremity following tumor resection is a common complication, and the treatment of these infections is challenging and often requires multiple surgical interventions or even implant removal. Because there has been limited evidence to support treatment strategies and understanding of the epidemiology of the causative microorganisms, we analyzed the effectiveness of debridement, antibiotics, and implant retention (DAIR), risk factors for the failure of DAIR, and causative microorganisms in patients with a PJI surrounding a lower-extremity endoprosthesis after tumor resection.

Methods: A retrospective cohort study was conducted in a tertiary referral center for orthopaedic oncology.

Implementation of multidisciplinary team decisions on the management of complex bone and joint infections: an observational study.

Background: Multidisciplinary team (MDT) management of prosthetic joint infections (PJI) and other bone and joint infections (BJI) is increasingly put into practice. However, studies evaluating the performance of MDTs in this field are scarce. We aimed to assess our MDT for complex BJI by determining the implementation rate of team decisions, analyzing factors associated with non-implementation and evaluating the clinical outcome of patients in whom MDT decisions were not implemented.

Targeted antimicrobial regimens for Gram-negative prosthetic joint infections: a prospective multicenter study.

Fluoroquinolones (FQs) are considered the most effective antimicrobial treatment for Gram-negative prosthetic joint infection (GN-PJI). Alternatives are needed due to increasing FQ resistance and side effects. We aimed to compare different targeted antimicrobial strategies for GN-PJI managed by debridement, antibiotics, and implant retention (DAIR) or one-stage revision surgery (1SR) and to review the literature of oral treatment options for GN-PJI.

Global practice variation of suppressive antimicrobial treatment for prosthetic joint infections: A cross-sectional survey study.

Objectives: To identify global differences in the use of suppressive antimicrobial therapy (SAT) in the management of prosthetic joint infection (PJI).

Methods: An online survey was designed to investigate clinician's approach to SAT for PJI, including indications, preferred antimicrobial drugs, dosing, treatment duration and follow-up. The survey was distributed to members of four international (bone and joint) infection societies and study groups.

Dosing and treatment duration of suppressive antimicrobial therapy in orthopedic implant infections: a cohort study.

: Limited data inform about the optimal dosing and duration of suppressive antimicrobial therapy (SAT) for orthopedic implant infection (OII). We aimed to compare the effectiveness of low-dosage with standard-dosage SAT and evaluate the safety of stopping SAT. : All patients with OII treated with SAT from 2011 to 2022 were retrospectively included.

Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis.

Prospero Registration Id: 367411.

Objectives: This systematic review and meta-analysis was conducted to assess the outcome of streptococcal hip and knee prosthetic joint infection (PJI) treated with Debridement, Antibiotics and Implant Retention (DAIR) and to evaluate risk factors associated with failure.

Methods: We conducted a systematic literature search on PubMed, Embase, Web of Science, and Cochrane library from inception until October 2021.

Influence of surface characteristics of implant materials on MRSA biofilm formation and effects of antimicrobial treatment.

Introduction: One of the main causes of treatment failure in bacterial prosthetic joint infections (PJI) is biofilm formation. The topography of the biofilm may be associated with susceptibility to antimicrobial treatment. The aims of this study were to assess differences in topography of biofilms on different implant materials and the correlation thereof with susceptibility to antimicrobial treatment.

Wound drainage after arthroplasty and prediction of acute prosthetic joint infection: prospective data from a multicentre cohort study using a telemonitoring app.

: Differentiation between uncomplicated and complicated postoperative wound drainage after arthroplasty is crucial to prevent unnecessary reoperation. Prospective data about the duration and amount of postoperative wound drainage in patients with and without prosthetic joint infection (PJI) are currently absent. : A multicentre cohort study was conducted to assess the duration and amount of wound drainage in patients after arthroplasty.

Effectiveness of Different Antimicrobial Strategies for Staphylococcal Prosthetic Joint Infection: Results From a Large Prospective Registry-Based Cohort Study.

Background: Treatment of staphylococcal prosthetic joint infection (PJI) usually consists of surgical debridement and prolonged rifampicin combination therapy. Tailored antimicrobial treatment alternatives are needed due to frequent side effects and drug-drug interactions with rifampicin combination therapy. We aimed to assess the effectiveness of several alternative antibiotic strategies in patients with staphylococcal PJI.

Modular component exchange and outcome of DAIR for hip and knee periprosthetic joint infection : a systematic review and meta-regression analysis.

Aims: The aim of this meta-analysis is to assess the association between exchange of modular parts in debridement, antibiotics, and implant retention (DAIR) procedure and outcomes for hip and knee periprosthetic joint infection (PJI).

Methods: We conducted a systematic search on PubMed, Embase, Web of Science, and Cochrane library from inception until May 2021. Random effects meta-analyses and meta-regression was used to estimate, on a study level, the success rate of DAIR related to component exchange.

[Prosthetic joint infection].

Prosthetic joint infection A prosthetic joint infection (PJI) is a serious complication that can lead to lengthy hospitalization, significant limitations in mobility, and a reduced quality of life. For acute PJI, the aim is to cure the infection whilst retaining the prosthesis; this can be achieved by means of thorough surgical debridement, cleaning of the artificial material, replacement of exchangeable prosthesis parts and adjuvant antibiotic therapy. In cases of chronic PJI, the prosthetic joint needs to be replaced.

The diagnostic value of F-FDG-PET/CT and MRI in suspected vertebral osteomyelitis - a prospective study.

Purpose: The aim of this study was to determine the diagnostic value of F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) and magnetic resonance imaging (MRI) in diagnosing vertebral osteomyelitis.

Methods: From November 2015 until December 2016, 32 patients with suspected vertebral osteomyelitis were prospectively included. All patients underwent both F-FDG-PET/CT and MRI within 48 h.

Assessing the public health risk of Shiga toxin-producing Escherichia coli by use of a rapid diagnostic screening algorithm.

Shiga toxin-producing Escherichia coli (STEC) is an enteropathogen of public health concern because of its ability to cause serious illness and outbreaks. In this prospective study, a diagnostic screening algorithm to categorize STEC infections into risk groups was evaluated. The algorithm consists of prescreening stool specimens with real-time PCR (qPCR) for the presence of stx genes.

[Invasive pulmonary aspergillosis in influenza].

Background: Invasive pulmonary aspergillosis (IPA) is a life-threatening infection that occurs predominantly in severely immunocompromised patients. Recently, IPA is also increasingly seen in less severely immunocompromised patients, such as patients with COPD receiving glucocorticoids and patients on ventilation in an IC unit.

Case Description: Here we present the case of a 59-year-old male who died of influenza complicated by a superinfection with Aspergillus fumigatus.