Cargando…
The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections
Currently, no guideline provides recommendations on the duration of empirical antimicrobial treatment (EAT) in prosthetic joint infection (PJI). The aim of our study was to describe the time to growth of bacteria involved in PJI, rendering possible decreased duration of EAT. Based on a French multic...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947470/ https://www.ncbi.nlm.nih.gov/pubmed/31810267 http://dx.doi.org/10.3390/jcm8122113 |
_version_ | 1783485558506389504 |
---|---|
author | Deroche, Luc Bémer, Pascale Valentin, Anne-Sophie Jolivet-Gougeon, Anne Tandé, Didier Héry-Arnaud, Geneviève Lemarié, Carole Kempf, Marie Bret, Laurent Burucoa, Christophe Corvec, Stéphane Plouzeau, Chloé |
author_facet | Deroche, Luc Bémer, Pascale Valentin, Anne-Sophie Jolivet-Gougeon, Anne Tandé, Didier Héry-Arnaud, Geneviève Lemarié, Carole Kempf, Marie Bret, Laurent Burucoa, Christophe Corvec, Stéphane Plouzeau, Chloé |
author_sort | Deroche, Luc |
collection | PubMed |
description | Currently, no guideline provides recommendations on the duration of empirical antimicrobial treatment (EAT) in prosthetic joint infection (PJI). The aim of our study was to describe the time to growth of bacteria involved in PJI, rendering possible decreased duration of EAT. Based on a French multicentre prospective cohort study, culture data from patients with confirmed hip or knee PJI were analysed. For each patient, five samples were processed. Time to positivity was defined as the first positive medium in at least one sample for virulent pathogens and as the first positive medium in at least two samples for commensals. Definitive diagnosis of polymicrobial infections was considered the day the last bacteria were identified. Among the 183 PJIs, including 28 polymicrobial infections, microbiological diagnosis was carried out between Day 1 (D1) and D5 for 96.7% of cases. There was no difference in the average time to positivity between acute and chronic PJI (p = 0.8871). Microbiological diagnosis was given earlier for monomicrobial than for polymicrobial infections (p = 0.0034). When an optimized culture of peroperative samples was carried out, almost all cases of PJI were diagnosed within five days, including polymicrobial infections. EAT can be re-evaluated at D5 according to microbiological documentation. |
format | Online Article Text |
id | pubmed-6947470 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-69474702020-01-13 The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections Deroche, Luc Bémer, Pascale Valentin, Anne-Sophie Jolivet-Gougeon, Anne Tandé, Didier Héry-Arnaud, Geneviève Lemarié, Carole Kempf, Marie Bret, Laurent Burucoa, Christophe Corvec, Stéphane Plouzeau, Chloé J Clin Med Article Currently, no guideline provides recommendations on the duration of empirical antimicrobial treatment (EAT) in prosthetic joint infection (PJI). The aim of our study was to describe the time to growth of bacteria involved in PJI, rendering possible decreased duration of EAT. Based on a French multicentre prospective cohort study, culture data from patients with confirmed hip or knee PJI were analysed. For each patient, five samples were processed. Time to positivity was defined as the first positive medium in at least one sample for virulent pathogens and as the first positive medium in at least two samples for commensals. Definitive diagnosis of polymicrobial infections was considered the day the last bacteria were identified. Among the 183 PJIs, including 28 polymicrobial infections, microbiological diagnosis was carried out between Day 1 (D1) and D5 for 96.7% of cases. There was no difference in the average time to positivity between acute and chronic PJI (p = 0.8871). Microbiological diagnosis was given earlier for monomicrobial than for polymicrobial infections (p = 0.0034). When an optimized culture of peroperative samples was carried out, almost all cases of PJI were diagnosed within five days, including polymicrobial infections. EAT can be re-evaluated at D5 according to microbiological documentation. MDPI 2019-12-02 /pmc/articles/PMC6947470/ /pubmed/31810267 http://dx.doi.org/10.3390/jcm8122113 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Deroche, Luc Bémer, Pascale Valentin, Anne-Sophie Jolivet-Gougeon, Anne Tandé, Didier Héry-Arnaud, Geneviève Lemarié, Carole Kempf, Marie Bret, Laurent Burucoa, Christophe Corvec, Stéphane Plouzeau, Chloé The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections |
title | The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections |
title_full | The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections |
title_fullStr | The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections |
title_full_unstemmed | The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections |
title_short | The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections |
title_sort | right time to safely re-evaluate empirical antimicrobial treatment of hip or knee prosthetic joint infections |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947470/ https://www.ncbi.nlm.nih.gov/pubmed/31810267 http://dx.doi.org/10.3390/jcm8122113 |
work_keys_str_mv | AT derocheluc therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT bemerpascale therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT valentinannesophie therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT jolivetgougeonanne therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT tandedidier therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT heryarnaudgenevieve therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT lemariecarole therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT kempfmarie therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT bretlaurent therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT burucoachristophe therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT corvecstephane therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT plouzeauchloe therighttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT derocheluc righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT bemerpascale righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT valentinannesophie righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT jolivetgougeonanne righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT tandedidier righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT heryarnaudgenevieve righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT lemariecarole righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT kempfmarie righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT bretlaurent righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT burucoachristophe righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT corvecstephane righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections AT plouzeauchloe righttimetosafelyreevaluateempiricalantimicrobialtreatmentofhiporkneeprostheticjointinfections |