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. 2021 May 1;21(1):401.
doi: 10.1186/s12879-021-06075-x.

Management of prosthetic joint infections in France: a national audit to identify key situations requiring innovation and homogenization

Marion Le Maréchal  1   2 , Zoé Cavalli  3 , Cécile Batailler  4 , Jean-François Gonzalez  5   6 , André Ferreira  7 , Sébastien Lustig  4 , Tristan Ferry  4   8 , Johan Courjon  9   10
Affiliations

Management of prosthetic joint infections in France: a national audit to identify key situations requiring innovation and homogenization

Marion Le Maréchal et al. BMC Infect Dis. .

Abstract

Background: Prosthetic joint infections (PJI) are one of the most serious complication of arthroplasty. The management of PJI needs a multidisciplinary collaboration between orthopaedic surgeon, infectious disease specialist and microbiologist. In France, the management of PJI is organized around reference centres (CRIOACs). Our main objective was to perform an audit through a questionnaire survey based on clinical cases, to evaluate how French physicians manage PJI. Eligible participants were all physicians involved in care of patients presenting a PJI. Physicians could answer individually, or collectively during a multidisciplinary team meeting dedicated to PJI. The survey consisted as three questionnaires organized in a total of six clinical cases.

Results: Answers from the CRIOACs to the three questionnaires were 92, 77, and 53%. Between 32 and 39% of respondents did not administer antibiotic prophylaxis despite positive S. aureus pre-operative documentation. One-stage exchange strategy was widely preferred in all clinical cases, with no difference between CRIOACs and other centres. Rifampicin was prescribed for S. aureus PJI, in a situation with (90-92%) or without any prosthesis (70%). There was no consensus for the total antibiotic regimen duration, with prescriptions from six to 12 weeks for a majority of respondents.

Conclusions: Surgical strategy for the management of PJI was homogenous with a preference for a one-stage exchange strategy. Medical management was more heterogenous, which reflects the heterogeneity of those infections and difficulties to perform studies with strong conclusions.

Keywords: Arthritis infection; Clinical audit; Joint prosthesis; Rifampin; Staphylococcus aureus; Surveys and questionnaires.

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Conflict of interest statement

None to declare.

Figures

Fig. 1
Fig. 1
Summary of the six clinical cases. PJI: Prosthetic joint infection
See this image and copyright information in PMC

References

    1. Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR, Infectious Diseases Society of America Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2013;56(1):e1–25. doi: 10.1093/cid/cis803. - DOI - PubMed
    1. Jämsen E, Huhtala H, Puolakka T, Moilanen T. Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J Bone Joint Surg Am. 2009;91(1):38–47. doi: 10.2106/JBJS.G.01686. - DOI - PubMed
    1. Peersman G, Laskin R, Davis J, Peterson M. Infection in total knee replacement: a retrospective review of 6489 total knee replacements. Clin Orthop. 2001;(392):15–23. - PubMed
    1. Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop. 2008;466(7):1710–1715. doi: 10.1007/s11999-008-0209-4. - DOI - PMC - PubMed
    1. Choong PFM, Dowsey MM, Carr D, Daffy J, Stanley P. Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampinbased regimen. Acta Orthop. 2007;78(6):755–765. doi: 10.1080/17453670710014527. - DOI - PubMed

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