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Periprothetische Infektion des rheumatologischen Patienten

Eine Herausforderung

Periprosthetic infections in patients with rheumatism

A challenge

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Zusammenfassung

Die steigende Anzahl an Implantationen wird zur Zunahme an periprothetischen Infektionen führen. Periprothetische Infektionen bei rheumatologischen Patienten, die oftmals eine immunsuppressive Therapie erhalten, sind für die behandelnden Ärzte eine Herausforderung dar. Die optimale Betreuung und Behandlung erfordert deshalb eine interdisziplinäre Abstimmung zwischen Orthopäden, Infektiologen und Rheumatologen.

Abstract

The increasing number of implantations will lead to more periprosthetic infections. Periprosthetic infections in patients with rheumatism, who are often undergoing immunosuppressive treatment, represent a challenge for the treating physicians. The optimal care and treatment therefore necessitate an interdisciplinary agreement between orthopedic surgeons, specialists for infections and rheumatologists.

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Literatur

  1. Corvec S et al (2012) Epidemiology and new developments in the diagnosis of prosthetic joint infection. Int J Artif Organs 35(10):923–934

    PubMed  Google Scholar 

  2. Zhu Y et al (2015) Risk factors for periprosthetic joint infection after total joint arthroplasty: A systematic review and meta-analysis. J Hosp Infect 89(2):82–89

    Article  CAS  PubMed  Google Scholar 

  3. Baek SH (2014) Identification and preoperative optimization of risk factors to prevent periprosthetic joint infection. World J Orthop 5(3):362–367

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bongartz T et al (2008) Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis. Arthritis Rheum 59(12):1713–1720

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jämsen E et al (2009) Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J Bone Joint Surg Am 91(1):38–47

    Article  PubMed  Google Scholar 

  6. Schrama JC et al (2010) Risk of revision for infection in primary total hip and knee arthroplasty in patients with rheumatoid arthritis compared with osteoarthritis: A prospective, population-based study on 108,786 hip and knee joint arthroplasties from the Norwegian Arthroplasty Register. Arthritis Care Res (Hoboken) 62(4):473–479

    Article  Google Scholar 

  7. Giles JT et al (2006) Tumor necrosis factor inhibitor therapy and risk of serious postoperative orthopedic infection in rheumatoid arthritis. Arthritis Rheum 55(2):333–337

    Article  PubMed  Google Scholar 

  8. Pappas DA, Giles JT (2008) Do antitumor necrosis factor agents increase the risk of postoperative orthopedic infections? Curr Opin Rheumatol 20(4):450–456

    Article  CAS  PubMed  Google Scholar 

  9. Renz N, Perka C, Trampuz A (2016) Management of periprosthetic infections of the knee. Orthopade 45(1):65–71

    Article  CAS  PubMed  Google Scholar 

  10. Zimmerli W, Trampuz A, Ochsner PE (2004) Prosthetic-joint infections. N Engl J Med 351(16):1645–1654

    Article  CAS  PubMed  Google Scholar 

  11. Winkler T et al (2014) Periprosthetic infection after hip arthroplasty. Orthopade 43(1):70–78

    Article  CAS  PubMed  Google Scholar 

  12. Jackson MS et al (1999) Oral carriage of staphylococci in patients with rheumatoid arthritis. Rheumatology (Oxford) 38(6):572–575

    Article  CAS  Google Scholar 

  13. Parvizi J, Gehrke T (2014) Infection, definition of periprosthetic joint infection. J Arthroplasty 29(7):1331 (The International Consensus Group on Periprosthetic Joint Infection)

    Article  PubMed  Google Scholar 

  14. Parvizi J, Gehrke T, Chen AF (2013) Proceedings of the international consensus on periprosthetic joint infection. Bone Joint J 95(11):1450–1452

    Article  PubMed  Google Scholar 

  15. Cipriano CA et al (2012) Serum and synovial fluid analysis for diagnosing chronic periprosthetic infection in patients with inflammatory arthritis. J Bone Joint Surg Am 94(7):594–600

    Article  PubMed  Google Scholar 

  16. Zmistowski B et al (2014) Diagnosis of periprosthetic joint infection. J Orthop Res 32(Suppl 1):S98–S107

    PubMed  Google Scholar 

  17. Parvizi J, Zmistowski B, Berbari EF et al (2011) New definition for periprosthetic joint infection. J Arthroplasty 26(8):1136–1138 (The Workgroup Convened by the Musculoskeletal Infection Society) doi:10.1016/j.arth.2011.09.026

    Article  Google Scholar 

  18. Della Valle C et al (2011) American Academy of Orthopaedic Surgeons clinical practice guideline on: The diagnosis of periprosthetic joint infections of the hip and knee. J Bone Joint Surg Am 93(14):1355–1357

    Article  PubMed  Google Scholar 

  19. Deirmengian C et al (2014) Diagnosing periprosthetic joint infection: Has the era of the biomarker arrived? Clin Orthop Relat Res 472(11):3254–3262

    Article  PubMed  PubMed Central  Google Scholar 

  20. Deirmengian C, Lonner JH, Booth RE (2005) The Mark Coventry Award: White blood cell gene expression: A new approach toward the study and diagnosis of infection. Clin Orthop Relat Res 440:38–44

    Article  Google Scholar 

  21. Deirmengian C et al (2015) The alpha-defensin test for periprosthetic joint infection responds to a wide spectrum of organisms. Clin Orthop Relat Res 473(7):2229–2235

    Article  PubMed  PubMed Central  Google Scholar 

  22. Deirmengian C et al (2010) Synovial fluid biomarkers for periprosthetic infection. Clin Orthop Relat Res 468(8):2017–2023

    Article  PubMed  PubMed Central  Google Scholar 

  23. Deirmengian C et al (2014) Combined measurement of synovial fluid α‑Defensin and C‑reactive protein levels: Highly accurate for diagnosing periprosthetic joint infection. J Bone Joint Surg Am 96(17):1439–1445

    Article  PubMed  Google Scholar 

  24. Borde JP et al (2015) Diagnosis of prosthetic joint infections using UMD-Universal Kit and the automated multiplex-PCR Unyvero i60 ITI(®) cartridge system: A pilot study. Infection 43(5):551–560

    Article  PubMed  Google Scholar 

  25. Rao N et al (2003) Long-term suppression of infection in total joint arthroplasty. Clin Orthop Relat Res 414:55–60

    Article  Google Scholar 

  26. Tsukayama DT, Wicklund B, Gustilo RB (1991) Suppressive antibiotic therapy in chronic prosthetic joint infections. Orthopedics 14(8):841–844

    CAS  PubMed  Google Scholar 

  27. Berbari EF et al (2006) Outcome of prosthetic joint infection in patients with rheumatoid arthritis: The impact of medical and surgical therapy in 200 episodes. Clin Infect Dis 42(2):216–223

    Article  PubMed  Google Scholar 

  28. Hsieh PH, Huang KC, Shih HN (2013) Prosthetic joint infection in patients with rheumatoid arthritis: An outcome analysis compared with controls. PLOS ONE 8(8):e71666

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Huang SS et al (2013) Targeted versus universal decolonization to prevent ICU infection. N Engl J Med 368(24):2255–2265

    Article  CAS  PubMed  Google Scholar 

  30. Bebko SP, Green DM, Awad SS (2015) Effect of a preoperative decontamination protocol on surgical site infections in patients undergoing elective orthopedic surgery with hardware implantation. JAMA Surg 150(5):390–395

    Article  PubMed  Google Scholar 

  31. Courville XF et al (2012) Cost-effectiveness of preoperative nasal mupirocin treatment in preventing surgical site infection in patients undergoing total hip and knee arthroplasty: A cost-effectiveness analysis. Infect Control Hosp Epidemiol 33(2):152–159

    Article  PubMed  Google Scholar 

  32. Donlan RM (2009) Preventing biofilms of clinically relevant organisms using bacteriophage. Trends Microbiol 17(2):66–72

    Article  CAS  PubMed  Google Scholar 

  33. Tzeng A et al (2015) Treating periprosthetic joint infections as biofilms: key diagnosis and management strategies. Diagn Microbiol Infect Dis 81(3):192–200

    Article  CAS  PubMed  Google Scholar 

  34. Bhattacharya M et al (2015) Prevention and treatment of Staphylococcus aureus biofilms. Expert Rev Anti Infect Ther 13(12):1499–1516

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Berlin, Deutschland

    J. Fussi, C. Perka & L. Renner

Authors
  1. J. Fussi
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  2. C. Perka
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  3. L. Renner
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Corresponding author

Correspondence to C. Perka.

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Interessenkonflikt

J. Fussi, C. Perka und L. Renner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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A. Radbruch, Berlin

H. Schulze-Koops, München

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Fussi, J., Perka, C. & Renner, L. Periprothetische Infektion des rheumatologischen Patienten. Z Rheumatol 75, 987–992 (2016). https://doi.org/10.1007/s00393-016-0204-1

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  • DOI: https://doi.org/10.1007/s00393-016-0204-1

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