1
|
Roschke E, Kluge T, Stallkamp F, Roth A, Zajonz D, Hoffmann KT, Sabri O, Kluge R, Ghanem M. Use of PET-CT in diagnostic workup of periprosthetic infection of hip and knee joints: significance in detecting additional infectious focus. INTERNATIONAL ORTHOPAEDICS 2021; 46:523-529. [PMID: 34618195 PMCID: PMC8840933 DOI: 10.1007/s00264-021-05218-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/12/2021] [Indexed: 12/15/2022]
Abstract
Introduction The diagnosis and management of periprosthetic knee and hip infections as well as the identification and management of possible additional infectious foci is of great importance for successful therapy. This study analyses the importance of 18F deoxyglucose PET-CT (PET-CT) in the identification of additional infectious focus and subsequent impact on management of periprosthetic infection (PPI). Material and methods A retrospective analysis of the clinical data and findings in the period from January 2008 to December 2018 was carried out. One hundred and four patients with in-hospital treatment due to PPI of a hip or knee joint were identified and included in this study. All patients underwent a standardized clinical examination and further surgical and antibiotic therapy. The reevaluation of performed PET-CTs was specifically carried out with regard to the local PPI or detection of secondary foci. Results PET-CT successfully verified the PPI in 84.2% of the patients. A total of 78 possible additional foci were detected in PET-CT in 56 (53.8%) of the examined patients. Predilection sites for possible secondary foci were joints (42.3%), pulmonary (15.4%), ear-nose-throat (15.4%), spine (11.5%), and the musculocutaneous tissues (11.5%). Fifty-four positive PET-CT findings were confirmed clinically with need of additional adequate treatment. Conclusion PET-CT is a valuable diagnostic tool to confirm periprosthetic joint infection. At the same time, the whole-body PET/CT may detect additional foci of infection with impact on subsequent treatment strategy. PET was of special value in detecting infections at distant locations far from the primary infected joint in significant number. These distant infection locations can be potential cause of a re-infection. This clearly reflects the need of their diagnosis.
Collapse
Affiliation(s)
- E Roschke
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
| | - T Kluge
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - F Stallkamp
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - A Roth
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - D Zajonz
- Klinik Für Orthopädie, Unfallchirurgie Und Wiederherstellungschirurgie, Zeißigwaldkliniken Bethanien Chemnitz, Chemnitz, Germany
| | - K T Hoffmann
- Klinik Und Poliklinik Für Diagnostische Und Interventionelle Radiologie, Institut Für Neuroradiologie, Leipzig, Germany
| | - O Sabri
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - R Kluge
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - M Ghanem
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| |
Collapse
|
2
|
Barberis C, Ledesma M, Álvarez C, Famiglietti A, Almuzara M, Vay C. [Analysis of the diversity of Actinomyces/Actinotignum clinical isolates in a university hospital]. Rev Argent Microbiol 2021; 53:202-209. [PMID: 33402284 DOI: 10.1016/j.ram.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/22/2020] [Accepted: 11/03/2020] [Indexed: 11/15/2022] Open
Abstract
Actinomyces and related genera are grampositive bacilli, opportunistic pathogens, which have been mainly involved in endogenous infections. However, due to the complexity in identifying them for most clinical laboratories, there is scant knowledge about their real clinical significance. In this work, 166 isolates of 13 different species of Actinomyces/Actinotignum species recovered from clinical samples of patients treated in a university hospital were studied. The identification was performed by MALDI-TOF MS and molecular identification. MALDI-TOF MS identified 91.57% of the isolates (152/166) at the species level using a score ≥ 1.7 and 3.61% (6/166) of the isolates were identified only at the gender level with a score ≥ 1.5. MALDI-TOF MS did not yield reliable identification results for 4.82% (8/166) of the isolates. Actinomyces/Actinotignum species were isolated from: soft tissue (n: 47), urine samples (n: 35), head / neck abscesses (n: 19), genital abscesses (n: 11), blood samples (n: 10), breast abscesses (n: 8), osteoarticular samples (n: 6), abdominal/ascitic fluids (n: 3), abdominal abscesses (n: 5), sputum/BAL (n: 4), brain abscesses (n: 3), and others (n: 15). The results obtained from the statistical analysis showed a high differential frequency (> 2) for the location/species association: urine/A. schaalii/sanguinis; brain abscesses/A. europaeus; osteoarticular samples/A. urogenitalis; abdominal abscesses/ A. turicensis; respiratory samples/A. naeslundii/viscosus. This information provides a greater understanding of the clinical and epidemiological relevance of these species. The pathogenic role of Actinomyces spp. will be increasingly revealed as these microorganisms could be recognized thanks to prolonged culture and the advances in identification technology facilitated by MALDI-TOF MS.
Collapse
Affiliation(s)
- Claudia Barberis
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Martín Ledesma
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carla Álvarez
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Angela Famiglietti
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Marisa Almuzara
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carlos Vay
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
3
|
Stojković D, Kostić M, Smiljković M, Aleksić M, Vasiljević P, Nikolić M, Soković M. Linking Antimicrobial Potential of Natural Products Derived from Aquatic Organisms and Microbes Involved in Alzheimer's Disease - A Review. Curr Med Chem 2020. [PMID: 29521212 DOI: 10.2174/0929867325666180309103645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The following review is oriented towards microbes linked to Alzheimer's disease (AD) and antimicrobial effect of compounds and extracts derived from aquatic organisms against specific bacteria, fungi and viruses which were found previously in patients suffering from AD. Major group of microbes linked to AD include bacteria: Chlamydia pneumoniae, Helicobacter pylori, Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia, Actinomyces naeslundii, spirochete group; fungi: Candida sp., Cryptococcus sp., Saccharomyces sp., Malassezia sp., Botrytis sp., and viruses: herpes simplex virus type 1 (HSV-1), Human cytomegalovirus (CMV), hepatitis C virus (HCV). In the light of that fact, this review is the first to link antimicrobial potential of aquatic organisms against these sorts of microbes. This literature review might serve as a starting platform to develop novel supportive therapy for patients suffering from AD and to possibly prevent escalation of the disease in patients already having high-risk factors for AD occurrence.
Collapse
Affiliation(s)
- Dejan Stojković
- Department of Plant Physiology, Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| | - Marina Kostić
- Department of Plant Physiology, Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| | - Marija Smiljković
- Department of Plant Physiology, Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| | - Milena Aleksić
- Department of Biology and Ecology, Faculty of Science and Mathematics, University of Nis, Visegradska 33, 18000 Nis, Serbia
| | - Perica Vasiljević
- Department of Biology and Ecology, Faculty of Science and Mathematics, University of Nis, Visegradska 33, 18000 Nis, Serbia
| | - Miloš Nikolić
- Department of Plant Physiology, Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| | - Marina Soković
- Department of Plant Physiology, Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| |
Collapse
|
4
|
Redmond SN, Helms R, Pensiero A. A Case of Actinomyces Prosthetic Hip Infection. Cureus 2020; 12:e9148. [PMID: 32789085 PMCID: PMC7417308 DOI: 10.7759/cureus.9148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Actinomyces is a species of gram-positive anaerobic commensal organisms found in the human oropharynx, gastrointestinal, and genitourinary tracts, which most often are implicated in cervicofacial infections. Rarely do these organisms cause joint infections. We present the case of a 68-year-old man with a prosthetic hip infection due to Actinomyces species. He underwent surgical incision and drainage with replacement of the prosthetic joint. Cultures grew Actinomyces species, and he was treated with a four-week course of ampicillin-sulbactam followed by eight weeks of amoxicillin-clavulanate. This organism is an uncommon pathogen, and few cases of prosthetic joint infection due to Actinomyces have previously been reported.
Collapse
|
5
|
Dagher R, Riaz T, Tande AJ, Osmon DR, Jagtiani A, Steckelberg JM, Mabry T, Berbari EF. Prosthetic Joint Infection due to Actinomyces species: A case series and review of literature. J Bone Jt Infect 2019; 4:174-180. [PMID: 31555503 PMCID: PMC6757008 DOI: 10.7150/jbji.35592] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/07/2019] [Indexed: 01/29/2023] Open
Abstract
Background: Actinomyces prosthetic joint infections (APJIs) are rare and optimal medical and surgical treatment strategies are unknown. The purpose of our study was to characterize the demographics, risk factors, management and outcomes of patients with PJIs due to Actinomyces spp. Methods: Using a retrospective cohort study design, the medical records of all patients with Actinomyces spp. total hip or knee arthroplasty infection (APJI) seen at a single institution between January 1, 1969 and December 31, 2016 were reviewed. We abstracted information including patient demographics, co-morbidities, joint age, surgical history, microbiology, management and outcomes. A simultaneous literature search via PubMed was performed to identify cases of APJI published in literature and a descriptive analysis was performed. Results: Eleven cases were identified over a 47 year study period at our institution. Seven patients (64%) were female. The median age at the time of diagnosis of infection was 71 years (range, 57-89). The knee was involved in six cases (55%) followed by the hip in 5 (45 %) cases. Three cases had dentures, broken teeth, or poor dentition. Actinomyces odonotlyticus was the most commonly found subspecies at our institution. Median ESR and CRP values were 61mm/hr and 64 mg/L respectively. Eight (72%) patients were managed with 2 stage exchange. Most patients received a course of beta-lactam therapy for 6 weeks. Ten cases (91%) were free of failure after a median duration of follow-up of 2 years (range, 0.67 - 5 years). The median duration from joint arthroplasty to the onset of symptoms was 162 days, range (20-3318). Six (54%) had a history of prior PJI with a different microorganism at the same joint site and 4 patients had history of prior 2 stage exchange (36%). In the literature group, we identified 12 cases and the most common subspecies was Actinomyces israelii; most patients underwent two stage exchange and were treated with 6 weeks of beta lactam antibiotics. Conclusions: Based on our observational study, Actinomyces PJI presents as a late complication of TJR, may be associated with prior PJI at the index joint and antecedent dental manipulation may portend as an additional risk factor. Treatment includes two stage exchange and beta- lactam therapy for 6weeks. These results will help clinicians in improved understanding and management of APJIs which although are rare but warrant special attention as population with implanted joint arthroplasties continues to rise.
Collapse
Affiliation(s)
- Ramez Dagher
- Department of Internal Medicine and Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905
| | - Talha Riaz
- Department of Internal Medicine and Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905
| | - Aaron J Tande
- Department of Internal Medicine and Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905
| | - Douglas R Osmon
- Department of Internal Medicine and Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905
| | - Anil Jagtiani
- Department of Internal Medicine and Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905
| | - James M Steckelberg
- Department of Internal Medicine and Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905
| | - Tad Mabry
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905
| | - Elie F Berbari
- Department of Internal Medicine and Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905
| |
Collapse
|
6
|
Rodríguez Duque JC, Galindo Rubín P, González Humara B, Quesada Sanz AA, Busta Vallina MB, Fernández-Sampedro M. Fusobacterium nucleatum prosthetic hip infection: Case report and review of the literature of unusual anaerobic prosthetic joint infection. Anaerobe 2018; 54:75-82. [PMID: 30118892 DOI: 10.1016/j.anaerobe.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 07/26/2018] [Accepted: 08/12/2018] [Indexed: 12/26/2022]
Abstract
The anaerobic Gram-negative rod Fusobacterium nucleatum is an oral commensal and periodontal pathogen that has been associated with a wide variety of infections, yet it is extremely rare to be associated with prosthetic joint infection. After an exhaustive literature review, only two cases of prosthetic joint infection by F. nucleatum have been previously reported. To our knowledge, the case we report on here is the first combined with periprosthetic abscess and related with hemochromatosis. We therefore sought to provide a comprehensive literature review of case reports or series of less commonly encountered anaerobic microorganisms isolated from prosthetic joint infections.
Collapse
Affiliation(s)
- J C Rodríguez Duque
- Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - P Galindo Rubín
- Department of Orthopaedic Surgery, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - B González Humara
- Department of Radiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - A A Quesada Sanz
- Service of Microbiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - M B Busta Vallina
- Department of Orthopaedic Surgery, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - M Fernández-Sampedro
- Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| |
Collapse
|
7
|
Shah NB, Tande AJ, Patel R, Berbari EF. Anaerobic prosthetic joint infection. Anaerobe 2015; 36:1-8. [DOI: 10.1016/j.anaerobe.2015.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/23/2015] [Accepted: 08/24/2015] [Indexed: 12/01/2022]
|
8
|
Abstract
Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been described. Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. With the introduction of advanced molecular methods, knowledge about their clinical relevance is gradually increasing, and the spectrum of diseases associated with Actinomyces and Actinomyces-like organisms is widening accordingly; for example, Actinomyces meyeri, Actinomyces neuii, and Actinomyces turicensis as well as Actinotignum (formerly Actinobaculum) schaalii are emerging as important causes of specific infections at various body sites. In the present review, we have gathered this information to provide a comprehensive and microbiologically consistent overview of the significance of Actinomyces and some closely related taxa in human infections.
Collapse
|
9
|
Villalonga ML, Díez P, Sánchez A, Gamella M, Pingarrón JM, Villalonga R. Neoglycoenzymes. Chem Rev 2014; 114:4868-917. [DOI: 10.1021/cr400290x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Paula Díez
- Department
of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, 28040-Madrid, Spain
| | - Alfredo Sánchez
- Department
of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, 28040-Madrid, Spain
| | - María Gamella
- Department
of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, 28040-Madrid, Spain
| | - José M. Pingarrón
- Department
of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, 28040-Madrid, Spain
- IMDEA
Nanoscience, Cantoblanco Universitary City, 28049-Madrid, Spain
| | - Reynaldo Villalonga
- Department
of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, 28040-Madrid, Spain
- IMDEA
Nanoscience, Cantoblanco Universitary City, 28049-Madrid, Spain
| |
Collapse
|
10
|
Chen A, Haddad F, Lachiewicz P, Bolognesi M, Cortes LE, Franceschini M, Gallo J, Glynn A, Gonzalez Della Valle A, Gahramanov A, Khatod M, Lazarinis S, Lob G, Nana A, Ochsner P, Tuncay I, Winkler T, Zeng Y. Prevention of late PJI. J Arthroplasty 2014; 29:119-28. [PMID: 24370487 DOI: 10.1016/j.arth.2013.09.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
|
11
|
Chen A, Haddad F, Lachiewicz P, Bolognesi M, Cortes LE, Franceschini M, Gallo J, Glynn A, Della Valle AG, Gahramanov A, Khatod M, Lazarinis S, Lob G, Nana A, Ochsner P, Tuncay I, Winkler T, Zeng Y. Prevention of late PJI. J Orthop Res 2014; 32 Suppl 1:S158-71. [PMID: 24464891 DOI: 10.1002/jor.22561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
12
|
Bacteremia Due to Actinomyces naeslundii in a T cell Lymphoma Child; a Case Report. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.6733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
13
|
Hedke J, Skripitz R, Ellenrieder M, Frickmann H, Köller T, Podbielski A, Mittelmeier W. Low-grade infection after a total knee arthroplasty caused by Actinomyces naeslundii. J Med Microbiol 2012; 61:1162-1164. [DOI: 10.1099/jmm.0.030395-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- J. Hedke
- Department of Orthopedics, University Hospital Rostock, Germany
| | - R. Skripitz
- Department of Orthopedics, University Hospital Rostock, Germany
| | - M. Ellenrieder
- Department of Orthopedics, University Hospital Rostock, Germany
| | - H. Frickmann
- Institute for Medical Microbiology, Virology and Hygiene, University Hospital Rostock, Germany
- Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital, Hamburg, Germany
| | - T. Köller
- Institute for Medical Microbiology, Virology and Hygiene, University Hospital Rostock, Germany
| | - A. Podbielski
- Institute for Medical Microbiology, Virology and Hygiene, University Hospital Rostock, Germany
| | - W. Mittelmeier
- Department of Orthopedics, University Hospital Rostock, Germany
| |
Collapse
|
14
|
Brown ML, Drinkwater CJ. Hematogenous infection of total hip arthroplasty with Actinomyces following a noninvasive dental procedure. Orthopedics 2012; 35:e1086-9. [PMID: 22784905 DOI: 10.3928/01477447-20120621-27] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This article describes a case of an infected total hip arthroplasty following a dental procedure. A 59-year-old man underwent total hip arthroplasty for osteoarthritis and had a routine recovery. Approximately 9 months postoperatively, he underwent a dental cleaning without antibiotic prophylaxis. One month later, he reported gradually worsening right hip pain and a purulent discharge. After several unsuccessful interventions, the patient was referred to the authors' facility. The patient's history, draining sinus tract, and radiographic changes were considered diagnostic of a late chronic infection, and the patient underwent 2-stage revision. Intraoperatively, the sinus tract extended directly to the acetabular component. Actinomyces spp were isolated from 3 of 7 intraoperative anaerobic cultures, and the patient received penicillin G for 8 weeks. Two weeks after discontinuing antibiotics, with no clinical manifestation of recurrent infection and a negative hip aspiration, a new hip prosthesis was implanted. The patient was prescribed penicillin for 12 months postoperatively. Harris Hip Score was 100 at 52-month follow-up. The American Dental Association and the American Academy of Orthopaedic Surgeons issued consensus guidelines for chemoprophylaxis in orthopedic patients undergoing dental procedures in 1997 and 2003. Although the American Academy of Orthopaedic Surgeons issued a revised guideline in 2009 recommending more robust antibiotic prophylaxis, significant controversy exists because at least one professional organization representing dentists has repudiated the 2009 American Academy of Orthopaedic Surgeons guideline. The authors describe the implications from their experience and similar cases in the literature with regard to such guidelines.
Collapse
Affiliation(s)
- Matthew L Brown
- University of Rochester School of Medicine & Dentistry, 601 Elmwood Ave, Box 665, Rochester, NY 14642, USA
| | | |
Collapse
|
15
|
Reichenbach J, Lopatin U, Mahlaoui N, Beovic B, Siler U, Zbinden R, Seger RA, Galmiche L, Brousse N, Kayal S, Güngör T, Blanche S, Holland SM. Actinomyces in chronic granulomatous disease: an emerging and unanticipated pathogen. Clin Infect Dis 2010; 49:1703-10. [PMID: 19874205 DOI: 10.1086/647945] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Chronic granulomatous disease (CGD) is a rare inherited disease of the phagocyte NADPH oxidase system that causes defective production of toxic oxygen metabolites, impaired bacterial and fungal killing, and recurrent life-threatening infections, mostly by catalase-producing organisms. We report for the first time, to our knowledge, chronic infections with Actinomyces species in 10 patients with CGD. Actinomycosis is a chronic granulomatous condition that commonly manifests as cervicofacial, pulmonary, or abdominal disease, caused by slowly progressive infection with oral and gastrointestinal commensal Actinomyces species. Treatment of actinomycosis is usually simple in immunocompetent individuals, requiring long-term, high-dose intravenous penicillin, but is more complicated in those with CGD because of delayed diagnosis and an increased risk of chronic invasive or debilitating disease. METHODS Actinomyces was identified by culture, staining, 16S ribosomal DNA polymerase chain reaction, and/or a complement fixation test in 10 patients with CGD. RESULTS All 10 patients presented with a history of fever and elevated inflammatory signs without evident focus. Diagnosis was delayed and clinical course severe and protracted despite high-dose intravenous antibiotic therapy and/or surgery. These results suggest an unrecognized and unanticipated susceptibility to weakly pathogenic Actinomyces species in patients with CGD because these are catalase-negative organisms previously thought to be nonpathogenic in CGD. CONCLUSIONS Actinomycosis should be vigorously sought and promptly treated in patients with CGD presenting with uncommon and prolonged clinical signs of infection. Actinomycosis is a catalase-negative infection important to consider in CGD.
Collapse
Affiliation(s)
- Janine Reichenbach
- Division of Immunology, University Children's Hospital, Zurich, Switzerland.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Septic Arthritis of the Knee in a Patient With Actinomyces meyeri Bacteremia. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2009. [DOI: 10.1097/ipc.0b013e31819fe439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
17
|
Actinomyces neuii subsp. neuii Associated with periprosthetic infection in total hip arthroplasty as causative agent. J Clin Microbiol 2009; 47:4183-4. [PMID: 19794032 DOI: 10.1128/jcm.01249-09] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Actinomyces neuii has until now not been described as a pathogen associated with periprosthetic infection in total joint replacement. The case presented here suggests that A. neuii subsp. neuii is a causative pathogen. The discussion and review of the literature indicate the impact that detection of Actinomyces species could have.
Collapse
|
18
|
Bettesworth J, Gill K, Shah J. Primary actinomycosis of the foot: a case report and literature review. THE JOURNAL OF THE AMERICAN COLLEGE OF CERTIFIED WOUND SPECIALISTS 2009; 1:95-100. [PMID: 24527123 DOI: 10.1016/j.jcws.2009.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Actinomycosis is an indolent, slowly progressive, suppurative infection caused by gram-positive branching bacteria of the genus Actinomyces. The organism is a member of the oral and gastrointestinal microflora of humans. The disease actinomycosis most commonly occurs in 3 body regions: cervicofacial (55% of patients), abdominopelvic (20%), and pulmonothoracic (15%). Involvement of other parts of the body is uncommon and usually secondary to a lesion in one or the other of the above sites. Extremity disease can occur by secondary involvement through direct extension or hematogenous spread. However, primary actinomycosis of an extremity is very rare. A case of primary actinomycosis of the foot in a Hispanic male and a literature review with an emphasis on primary actinomycosis of the extremity are presented in this article.
Collapse
Affiliation(s)
- Jacob Bettesworth
- Kansas City School of Medicine and Biosciences, Kansas City, KS, USA
| | - Kirandeep Gill
- Kansas City School of Medicine and Biosciences, Kansas City, KS, USA
| | - Jayesh Shah
- Southwest Center for Wound Care and Hyperbaric Medicine, Southwest General Hospital, San Antonio, TX, USA
| |
Collapse
|
19
|
Marculescu CE, Berbari EF, Cockerill FR, Osmon DR. Unusual aerobic and anaerobic bacteria associated with prosthetic joint infections. Clin Orthop Relat Res 2006; 451:55-63. [PMID: 16906072 DOI: 10.1097/01.blo.0000229317.43631.81] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The association of certain microorganisms, such as Staphylococcus epidermidis, Staphylococcus aureus, and beta-hemolytic streptococci, with prosthetic joint infection (PJI) has been recognized for many years. To our knowledge, a systematic review of the presentation and management of less commonly encountered species of coagulase-negative staphylococci, nutritional-variant streptococci, aerobic non-spore and spore forming Gram-positive or anaerobic bacteria is not available. We therefore sought to provide a comprehensive literature review of PJI due to these microorganisms that will provide a valuable and quick reference for clinicians caring for these patients. We conducted a Medline search of all case reports and case series of PJI due to unusual aerobic and anaerobic bacteria. The presentation, surgical, and medical management strategies were reviewed. Appropriate medical and surgical management of such infections is complex and evolving as newer diagnostic tests, surgical techniques and antimicrobials become available. Management of patients with these infections requires close collaboration between the orthopaedic surgeon, infectious disease specialist and microbiology laboratory.
Collapse
|
20
|
Rendle PM, Seger A, Rodrigues J, Oldham NJ, Bott RR, Jones JB, Cowan MM, Davis BG. Glycodendriproteins: a synthetic glycoprotein mimic enzyme with branched sugar-display potently inhibits bacterial aggregation. J Am Chem Soc 2004; 126:4750-1. [PMID: 15080658 DOI: 10.1021/ja031698u] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The continuing ability of bacteria to resist current antibiotic treatments highlights the need for alternative strategies for inhibiting their pathogenicity. Bacterial attachment is a major factor in infectivity and virulence. This key binding phase of bacteria to any potential host is mediated by adhesin proteins and so these present an attractive therapeutic target for antiinfective blocking strategies. However, the natural ligands to adhesins are large, typically complex molecules that are difficult to mimic with small molecules. We describe here a method that creates precise synthetic mimics of glycoproteins that are designed to bind adhesins. By using protein-degrading enzymes as the basis for these mimics we have created large-molecule protein ligands that inhibit aggregation of pathogenic bacteria at levels greater than a million-fold higher than small-molecule inhibitors of adhesins.
Collapse
Affiliation(s)
- Phillip M Rendle
- Department of Chemistry, University of Oxford, Mansfield Road, Oxford OX1 3TA, UK
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Zaman R, Abbas M, Burd E. Late prosthetic hip joint infection with Actinomyces israelii in an intravenous drug user: case report and literature review. J Clin Microbiol 2002; 40:4391-2. [PMID: 12409439 PMCID: PMC139703 DOI: 10.1128/jcm.40.11.4391-4392.2002] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Late infections with Actinomyces israelii have been described for prosthetic hip joints but not in association with intravenous drug use. We present a case of a 43-year-old intravenous drug user who developed A. israelii infection in connection with a hip prosthesis 11 years after implantation, and we review four previously reported cases of Actinomyces prosthetic joint infections.
Collapse
Affiliation(s)
- Rana Zaman
- Division of Infectious Diseases. Department of Pathology, Henry Ford Health System, Detroit, Michigan 48202, USA
| | | | | |
Collapse
|
22
|
Lequerré T, Nouvellon M, Kraznowska K, Bruno MC, Vittecoq O, Mejjad O, Daragon A, Le Loët X. Septic arthritis due to Actinomyces naeslundii: report of a case. Joint Bone Spine 2002; 69:499-501. [PMID: 12477236 DOI: 10.1016/s1297-319x(02)00437-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In a man with osteoarthritis of the knee, Actinomyces naeslundii septic arthritis developed after intra-articular injection of hyaluronate. Actinomyces is an anaerobic Gram-positive rod. The outcome was favorable after treatment with two antibiotics and arthroscopy. The nature of the organism and its location to a joint are unusual features of this case, which illustrates the need to search for a septic complication before accepting a diagnosis of inflammation related to hyaluronate injection.
Collapse
Affiliation(s)
- Thierry Lequerré
- Rheumatology Department, Rouen University Hospital Charles-Nicolle, Unit INSERM 519, IFR 23, 76000 Rouen cedex 76031, France
| | | | | | | | | | | | | | | |
Collapse
|