Prosthetic Joint Infections: an Update

被引:39
|
作者
Abad, C. L. [1 ]
Haleem, A. [2 ]
机构
[1] Univ Philippines, Philippine Gen Hosp, Sect Infect Dis, Dept Med, Taft Ave, Manila, Philippines
[2] Univ Wisconsin Hosp & Clin, Div Infect Dis, Dept Internal Med, Madison, WI 53705 USA
关键词
Prosthetic joint infection; Diagnosis; Management; Controversies; Suppressive antibiotic therapy; TOTAL-HIP-ARTHROPLASTY; SURGICAL SITE INFECTION; TOTAL KNEE ARTHROPLASTY; BLOOD-CELL COUNTS; BROAD-RANGE PCR; RISK-FACTORS; SYNOVIAL-FLUID; PERIPROSTHETIC INFECTION; ASYMPTOMATIC BACTERIURIA; RHEUMATOID-ARTHRITIS;
D O I
10.1007/s11908-018-0622-0
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Purpose of Review Prosthetic joint infection (PJI) is a rare but serious complication that is frequently misdiagnosed. We aimed to highlight the nuances of PJI diagnosis and antimicrobial therapies and provide clarity in key areas of management. Recent Findings Current research in PJI centers on a potential role for diagnostic biomarkers, molecular techniques, and implant sonication to reduce culture-negativity rates. The optimal duration of antimicrobial therapy remains controversial. Summary A high clinical index of suspicion for PJI combined with data from multiple preoperative and intraoperative tests enables timely diagnosis and treatment. Biomarkers, molecular methods, and implant sonication are currently adjunctive to traditional diagnostic techniques. Shorter courses of antimicrobial therapies as well as the role of chronic suppressive therapy need confirmation by randomized controlled trials. Existing practices for preoperative dental prophylaxis and treatment of asymptomatic bacteriuria warrant revision based on evidence arguing against risk for PJI.
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页数:13
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