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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 14 - 14
1 Dec 2017
Zeller M Granier M Auber T Graff W Strat VL Lhotellier L Blandine M Marmor S Meyssonnier V Mouton A Passeron D Zeller V Klein E Heym B
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Aim

Periprosthetic joint infection (PJI) is nowadays the most important problem leading to failure in primary and revision total knee (TKA) and total hip arthroplasty (THA), therefore accurate diagnosis of PJI is necessary. We evaluated a commercial multiplex PCR system1 for diagnosis of PJI in joint aspiration fluids prior to surgery.

Method

A total of 32 patients were included in the study. Twenty-four patients had TKA and eight had THA. Joint aspiration fluids were examined by standard bacteriological procedures. Excess material of joint aspirates was frozen at −20°C until testing by multiplex PCR1. Inclusion criteria were a minimum leucocyte count of 2.000 per ml and at least 60% of polymorphonucleaur neutrophils (PNN) in the joint aspiration fluid.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 83 - 83
1 Dec 2017
Bart G Meyssonnier V Kerroumi Y Lhotellier L Graff W Passeron D Mouton A Ziza JM Desplaces N Marmor S Zeller V
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Aim

Treatment of chronic prosthetic joint infection (PJI) combines exchange arthroplasty and effective antibiotic therapy. Staphylococci are the most frequent microorganism isolated in PJIs, with resistance to methicillin found in 15–50% of the cases. Data from randomized trials on treatment of methicillin-resistant staphylococci are lacking and the choice of antibiotic(s) and recommendations vary according to authors. To date, combination therapy including vancomycin is the treatment of choice.

Minocycline, a cyclin antibiotic, is naturally effective against methicillin-resistant staphylococci. We use this antibiotic since many years in combination with vancomycin for the treatment of multi-drug resistant staphylococcal bone and joint infections.

The aim of this study is to analyze the outcome of patients treated with combination antibiotic therapy including minocycline for the treatment of chronic methicillin-resistant staphylococcal PJI.

Method

We conducted a cohort study between 2004 and 2014 in our referral center for bone and joint infections. Data were extracted from the prospective database. All the patients receiving an initial combination therapy including at least 4 weeks of minocycline, given orally, and another IV antibiotic, usually high-dose continuous IV vancomycin, for chronic MR staphylococcal PJI and who underwent one or two stage exchange arthroplasty, were included. They were followed prospectively for at least 2 years.