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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...

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Autores principales: 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
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
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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.
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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
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