header advert
Results 1 - 9 of 9
Results per page:
Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_15 | Pages 9 - 9
1 Dec 2021
Ferry T Conrad A Senneville E Roux S Dupieux-Chabert C Dinh A Lustig S Goutelle S Briot T Pham T Valour F
Full Access

Aim

Tedizolid is an oxazolidinone antibiotic that: (i) is recommended at the dose of 200 once daily in patients with skin and soft tissue infection; (ii) seems to have a better long-term hematological and neurological safety profile in comparison with linezolid; (iii) remains active on multidrug-resistant (MDR) Gram-positive pathogens. Consequently, it might represent an option as suppressive antimicrobial treatment (SAT) in patients with complex implant-associated bone and joint infection (BJI) due to MDR Gram-positive pathogens.

Method

We performed a cohort study (2017–2020) to evaluate the long-term safety of tedizolid (200mg qd) as SAT in patients with implant-associated BJI. In all cases, the use of tedizolid was validated as the last oral treatment option during multidisciplinar meetings in a reference center for the management of BJI. Serious adverse events, any reason for discontinuation, and standard biological data, were prospectively collected.


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_15 | Pages 49 - 49
1 Dec 2021
Trecourt A Brevet M Champagnac A Conrad A Josse J Dupieux-Chabert C Valour F Ferry T
Full Access

Aim

The aim of this study was to confirm that Mirra's criterion (≥ 5 Polymorphonuclears (PMNs) per field in 5 high power fields (HPFs)) is not adequate for diagnosis of chronic bone and joint infections (BJIs) due to Cutibacterium acnes (C. acnes). The second objective was to determine if plasma-cell infiltration, that is a classical marker of chronic inflammation, could be useful for the diagnosis of chronic BJIs due to C. acnes.

Methods

We retrospectively selected 25 patients from 2009 to 2013 with chronic BJIs due to C. acnes. In addition of Mirra's criterion, the number of plasma-cells (≥5 plasma-cells/5 HPFs, defined as “CRIOAc Lyon's criterion”) was implemented in the histopathological analysis. Patients were defined as infected, if at least one of the two criteria were present.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 27 - 27
1 Dec 2019
Triffault-Fillit C Eugenie M Karine C Becker A Evelyne B Michel T Goutelle S Fessy M Dupieux C Laurent F Lustig S Chidiac C Ferry T Valour F
Full Access

Aim

The use of piperacillin/tazobactam with vancomycin as empirical antimicrobial therapy (EAT) for prosthetic joint infection (PJI) has been associated with an increased risk of acute kidney injury (AKI), leading to propose cefepim as an alternative since 2017 in our reference center. The present study compared microbiological efficacy and tolerance of these two EAT strategies.

Method

All patients with PJI empirically treated by vancomycin-cefepim (n=90) were prospectively enrolled in an observational study, and compared with vancomycin-piperacillin/tazobactam-treated historical controls (n=117), regarding: i) the proportion efficacious empirical regimen (i.e., at least one of the two molecules active against the identified organism(s) based on in vitro susceptibility testing); and ii) the incidence of empirical therapy-related adverse events (AE), classified according to the Common terminology criteria for AE (CTCAE).


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 68 - 68
1 Dec 2018
Abad L Diot A Josse J Tasse J Lustig S Ferry T Laurent F Valour F
Full Access

Aim

Leading etiology of Bone and Join infections (BJI), Staphylococcus aureus (SA) is responsible for difficult-to-treat infections mainly because of three persistence factors: (i) biofilm formation, (ii) persistence within bone cells and (iii) switch to the small colony variant (SCV) phenotype. The impact of rifampin on these mechanisms gave it a prominent place in orthopedic device-associated BJI. However, resistance emergence, intolerance and drug interactions cause significant concerns. In this context, other rifamycins – namely rifapentine and rifabutin – have poorly been evaluated, particularly toward their ability to eradicate biofilm-embedded and intracellular reservoirs of SA.

Method

This study aimed at comparing the intracellular activities of and SCV induction by rifampin, rifabutin and rifapentine in an in vitro model of osteoblast infection. Four concentrations were tested (0.1xMIC, MIC, 10xMIC, 100xMIC) against three SA strains (6850 and two clinical isolates involved in recurrent BJI)


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 49 - 49
1 Dec 2017
Becker A Valour F Perpoint T Boussel L Ruffion A Laurent F Senneville E Chidiac C Ferry T
Full Access

Aim

Pubic osteomyelitis (PO) is one of less frequent Bone and Joint Infections forms (BJI). Its management is still poorly codified as far as nosological framework is still unclear in medical literature. We aim to describe PO epidemiology and to look for factors associated with management failure.

Method

We performed a retrospective cohort study, carried out in two Reference Centres, including patients with PO in 2010–2016. Treatment failure was defined by: (i) persistence of clinical signs despite treatment; (ii) clinical relapse with same microorganisms; (iii) infection recurrence with one or more different microorganism(s);

(iv) new signs of infection (abscess, sinus tract) in same area, without recourse to get microbiological documentation. Factors associated with management failure were determined by univariate Cox analysis (hazard ratio [HR] and 95% confidence interval calculation). Kaplan-Meier curve were compared between groups by log-rank test.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 75 - 75
1 Dec 2017
Chauvelot P Ferry T Triffault-Fillit C Braun E Perpoint T Laurent F Michel-Henry F Lustig S Chidiac C Valour F
Full Access

Aim

Corynebacterium is a rare etiologic agent of BJI. We aimed to describe this rare clinical condition and to assess treatment failure determinants.

Method

All adult patients with proven Corynebacterium BJI (i.e. consistent clinical/radiological signs, AND ≥2 reliable positive bacteriological samples, AND treated as such) were included in a retrospective cohort study. After cohort description, determinants of treatment failure (i.e, infection persistence, relapse, requirement of additional surgical procedure, and BJI-related death) were determined using stepwise logistic regression and Kaplan Meier curve analysis.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 72 - 72
1 Dec 2017
Triffault-Fillit C Valour F Michel T Goutelle S Guillo R Lustig S Fessy M Laurent F Eugenie M Chidiac C Ferry T
Full Access

Aim

Current guidelines recommend the combination of vancomycin with either piperacillin-tazobactam (PT) or a third generation cephalosporin (3GC) as empirical antimicrobial therapy of PJI, immediately after surgery. However, clinical and biological safeties of such high dose-combinations are poorly known.

Method

All patients managed in a reference center in France between 2011 and 2016 receiving an empirical antimicrobial therapy for PJI were included in a prospective cohort study. Antimicrobial-related AE upcoming during the empirical treatment phase were describe according to the Common Terminology Criteria for Adverse Events (CTCEA), and severe ones (grade ≥ 3) were reported to pharmacovigilance. AE determinants were assessed using univariate logistic regression.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 24 - 24
1 Dec 2017
Ferry T Johan A Boucher F Chateau J Hristo S Daoud F Braun E Triffault-Fillit C Perpoint T Laurent F Alain-Ali M Chidiac C Valour F
Full Access

Aim

A two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitis but has not been widely evaluated.

Method

Adult patients with pressure ulcer-related pelvic osteomyelitis treated by a two-stage surgical strategy were included in a retrospective cohort study. Determinants of superinfection (i.e., additional microbiological findings at reconstruction) and treatment failure were assessed using binary logistic regression and Kaplan-Meier curve analysis.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_23 | Pages 48 - 48
1 Dec 2016
Sophie T Dupieux C Camus C Chidiac C Lustig S Ferry T Laurent F Valour F
Full Access

Aim

Intracellular persistence of S. aureus is believed to be one of the major mechanisms leading to bone and joint infection (BJI) chronicity and relapses. Despite its poor intracellular activity, daptomycin (DAP) is increasingly used in the treatment of staphylococcal BJI. The well-known in vitro synergy of daptomycin with various betalactam antibiotics consequently led us to investigate whether these combinations enhance the activity of daptomycin against the intracellular reservoir of methicillin-susceptible (MSSA) and -resistant (MRSA) S. aureus in an ex-vivo model of human osteoblast infection.

Method

Osteoblastic MG63 cells were infected for 2h with MSSA strain or its isogenic MRSA. After killing the remaining extracellular bacteria with lysostaphin, infected cells were then incubated for 24h with DAP, oxacillin (OXA) or ceftaroline (CPT) alone or in combination, at the intraosseous concentrations reached with standard human therapeutic doses. Intracellular bacteria were then quantified by plating cell lysates. Minimum inhibitory concentrations (MICs) of these molecules alone and in combination were determined using the checkerboard method at pH7, but also at pH5 to mimic intracellular conditions.