Journal of Bone and Joint Infection最新文献

{"title":"What is the agreement between principles and practice of antibiotic stewardship in the management of diabetic foot infection: an in-hospital quality control study.","authors":"Noémie Reinert, Katinka Wetzel, Fabian Franzeck, Mario Morgenstern, Markus Aschwanden, Thomas Wolff, Martin Clauss, Parham Sendi","doi":"10.5194/jbji-9-183-2024","DOIUrl":"10.5194/jbji-9-183-2024","url":null,"abstract":"<p><p><b>Introduction</b>: Standardization of diagnostic and treatment concepts in diabetes-related foot infection (DFI) is challenging. In 2019, specific recommendations regarding diagnostic principles and antibiotic therapy (ABT) for DFI, including the one for osteomyelitis (DFO), were introduced in our institution. In this study, we assessed the adherence to these in-house guidelines 2 years after their implementation. <b>Methods</b>: Adult patients with DFI with and without DFO who underwent surgical intervention between 2019 and 2021 were included. Patients' charts were retrospectively reviewed. Accordance to recommendations regarding biopsy sampling, labeling, requesting microbiological and histopathological examinations, and treatment duration were assessed. <b>Results</b>: A total of 80 patients with 117 hospital episodes and 163 surgical interventions were included; 84.6 % required an amputation. Patients with HbA1c levels of <math><mrow><mo><</mo> <mn>6.5</mn></mrow> </math>  % more often required a revision during the same hospitalization than those with HbA1c levels of <math><mrow><mo>≥</mo> <mn>6.5</mn></mrow> </math>  % (29.4 % vs. 12.1 %, respectively, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.023</mn></mrow> </math> ). Specimens were obtained in 71.8 % of operations and sent for histological examination in 63.2 %. The mean duration of ABT was 9 (interquartile range (IQR) 5-15) d in macroscopically surgically cured episodes and 40.5 (IQR 15-42) d in cases with resection margins in non-healthy bone ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.0001</mn></mrow> </math> ). Treatment duration results were similar when using histological results: 13 (IQR 8-42) d for healthy bone vs. 29 (IQR 13-42) d for resection margins consistent with osteomyelitis ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.026</mn></mrow> </math> ). <b>Conclusion</b>: The adherence to recommendations in terms of biopsy sampling was good, moderate for histopathological analysis and poor for labeling the anatomic location. Adherence to recommendations for ABT duration was good, but further shortening of treatment duration for surgically cured cases is necessary.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"9 3","pages":"183-190"},"PeriodicalIF":1.8,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It is time for a unified definition of native vertebral osteomyelitis: a framework proposal.","authors":"Francesco Petri, Omar Mahmoud, Said El Zein, Ahmad Nassr, Brett A Freedman, Jared T Verdoorn, Aaron J Tande, Elie F Berbari","doi":"10.5194/jbji-9-173-2024","DOIUrl":"10.5194/jbji-9-173-2024","url":null,"abstract":"<p><p>In recent years, there has been a notable increase in research output on native vertebral osteomyelitis (NVO), coinciding with a rise in its incidence. However, clinical outcomes remain poor, due to frequent relapse and long-term sequelae. Additionally, the lack of a standardized definition and the use of various synonyms to describe this condition further complicate the clinical understanding and management of NVO. We propose a new framework to integrate the primary diagnostic tools at our disposal. These collectively fall into three main domains: clinical, radiological, and direct evidence. Moreover, they and can be divided into seven main categories: (a) clinical features, (b) inflammatory biomarkers, (c) imaging techniques, microbiologic evidence from (d) blood cultures and (e) invasive techniques, (f) histopathology, and (g) empirical evidence of improvement following the initiation of antimicrobial therapy. We provide a review on the evolution of these techniques, explaining why no single method is intrinsically sufficient to formulate an NVO diagnosis. Therefore, we argue for a consensus-driven, multi-domain approach to establish a comprehensive and universally accepted definition of NVO to enhance research comparability, reproducibility, and epidemiological tracking. Ongoing research effort is needed to refine these criteria further, emphasizing collaboration among experts through a Delphi method to achieve a standardized definition. This effort aims to streamline research, expedite accurate diagnoses, optimize diagnostic tools, and guide patient care effectively.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"9 3","pages":"173-182"},"PeriodicalIF":1.8,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related differences in periprosthetic joint infection research.","authors":"Domenico De Mauro, Cesare Meschini, Giovanni Balato, Tiziana Ascione, Enrico Festa, Davide Bizzoca, Biagio Moretti, Giulio Maccauro, Raffaele Vitiello","doi":"10.5194/jbji-9-137-2024","DOIUrl":"10.5194/jbji-9-137-2024","url":null,"abstract":"<p><p><b>Introduction</b>: Periprosthetic joint infections (PJIs) have emerged as a focal point in the realm of orthopedics, garnering widespread attention owing to the escalating incidence rates and the profound impact they impose on patients undergoing total joint arthroplasties (TJAs). Year after year, there has been a growing trend in the analysis of multiple risk factors, complication rates, and surgical treatments in the field. This study aims to illuminate the status of the sex-related differences in periprosthetic joint infections and advance research in this field. <b>Methods</b>: A systematic review was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The final reference list comprised longitudinal studies (both retrospective and prospective) and randomized controlled trials. A sex-based analysis was conducted to assess differences between males and females. <b>Results</b>: A total of 312 studies were initially identified through online database searches and reference investigations. Nine studies were subsequently included in the review. Eight out of nine studies examined the risk of developing PJI after total joint replacement. Notably, only half of these studies demonstrated a statistically significant value, with a <math><mi>p</mi></math>  value  <math><mrow><mi><</mi> <mn>0.05</mn></mrow> </math> , indicating a higher risk of infectious complications in males compared to females. <b>Conclusion</b>: According to the current literature, there appears to be a propensity for males to develop periprosthetic joint infection after total joint arthroplasty at a higher rate than the female population. Enhancing sex-related analysis in this field is imperative for gathering more robust evidence and insights.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"9 2","pages":"137-142"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing the definition of treatment success alters treatment outcomes in periprosthetic joint infection: a systematic review and meta-analysis.","authors":"Eytan M Debbi, Tyler Khilnani, Ioannis Gkiatas, Yu-Fen Chiu, Andy O Miller, Michael W Henry, Alberto V Carli","doi":"10.5194/jbji-9-127-2024","DOIUrl":"10.5194/jbji-9-127-2024","url":null,"abstract":"<p><p><b>Background</b>: Variability in the definition of treatment success poses difficulty when assessing the reported efficacy of treatments for hip and knee periprosthetic joint infection (PJI). To address this problem, we determined how definitions of PJI treatment success have changed over time and how this has affected published rates of success after one-stage and two-stage treatments for hip and knee PJI. <b>Methods</b>: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted to identify one-stage and two-stage revision hip and knee PJI publications in major databases (2006-2021). Definition of treatment success, based on Musculoskeletal Infection Society tier criteria, was identified for each study. Publication year, number of patients, minimum follow-up, and study quality were also recorded. The association of success definitions and treatment success rate was measured using multi-variable meta-regression. <b>Results</b>: Study quality remained unchanged in the 245 publications included. Over time, no antibiotics (tier 1) and no further surgery (tier 3) (40.7 % and 54.5 %, respectively) became the two dominant criteria. After controlling for type of surgery, study quality, study design, follow-up, and year of publication, studies with less strict success definitions (tier 3) reported slightly higher odds ratios of 1.05 [1.01, 1.10] ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.009</mn></mrow> </math> ) in terms of treatment success rates compared to tier 1. <b>Conclusions</b>: PJI researchers have gravitated towards tier-1 and tier-3 definitions of treatment success. While studies with stricter definitions had lower PJI treatment success, the clinical significance of this is unclear. Study quality, reflected in the methodological index for non-randomized studies (MINORS) score, did not improve. We advocate for improving PJI study quality, including clarification of the definition of treatment success.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"9 2","pages":"127-136"},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequent microbiological profile changes are seen in subsequent-revision hip and knee arthroplasty for prosthetic joint infection","authors":"Robert A. McCulloch, Alex Martin, Bernadette C. Young, Benjamin J. Kendrick, Abtin Alvand, Lee Jeys, Jonathan Stevenson, Antony J. Palmer","doi":"10.5194/jbji-8-229-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-229-2023","url":null,"abstract":"Abstract. A proportion of patients with hip and knee prosthetic joint infection (PJI) undergo multiple revisions with the aim of eradicating infection and improving quality of life. The aim of this study was to describe the microbiology cultured from multiply revised hip and knee replacement procedures to guide antimicrobial therapy at the time of surgery. Patients and methods: Consecutive patients were retrospectively identified from databases at two specialist orthopaedic centres in the United Kingdom between 2011 and 2019. Patient were included who had undergone repeat-revision total knee replacement (TKR) or total hip replacement (THR) for infection, following an initial failed revision for infection. Results: A total of 106 patients were identified. Of these patients, 74 underwent revision TKR and 32 underwent revision THR. The mean age at first revision was 67 years (SD 10). The Charlson comorbidity index was ≤ 2 for 31 patients, 3–4 for 57 patients, and ≥ 5 for 18 patients. All patients underwent at least two revisions, 73 patients received three, 47 patients received four, 31 patients received five, and 21 patients received at least six. After six revisions, 90 % of patients had different organisms cultured compared with the initial revision, and 53 % of organisms were multidrug resistant. The most frequent organisms at each revision were coagulase-negative Staphylococcus (36 %) and Staphylococcus aureus (19 %). Fungus was cultured from 3 % of revisions, and 21 % of infections were polymicrobial. Conclusion: Patients undergoing multiple revisions for PJI are highly likely to experience a change in organism, with 90 % of patients having a different organism cultured by their sixth revision. It is therefore important to administer empirical antibiotics at each subsequent revision, taking into account known drug resistance from previous cultures. Our results do not support the routine use of empirical antifungals.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"53 17","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135820295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial prophylaxis with teicoplanin plus gentamicin in primary total joint arthroplasty","authors":"Tariq Azamgarhi, Craig Gerrand, John A. Skinner, Alexander Sell, Robert A. McCulloch, Simon Warren","doi":"10.5194/jbji-8-219-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-219-2023","url":null,"abstract":"Abstract. Objectives: To compare prosthetic joint infection (PJI) and acute kidney injury (AKI) rates among cohorts before and after changing our hospital's antimicrobial prophylactic regimen from cefuroxime to teicoplanin plus gentamicin. Methods: We retrospectively studied all patients undergoing primary total joint arthroplasty at our hospital 18 months pre- and post-implementation of the change in practice. All deep infections identified during follow-up were assessed against the European Bone and Joint Infection Society (EBJIS) definitions for PJI. Survival analysis using Cox regression was employed to adjust for differences in baseline characteristics and compare the risk of PJI between the groups. AKIs were identified using pathology records and categorized according to the KDIGO (Kidney Disease – Improving Global Outcomes) criteria. AKI rates were calculated for the pre- and post-intervention periods. Results: Of 1994 evaluable patients, 1114 (55.9 %) received cefuroxime only (pre-intervention group) and 880 (44.1 %) patients received teicoplanin plus gentamicin (post-intervention group). The overall rate of PJI in our study was 1.50 % (30 of 1994), with a lower PJI rate in the post-intervention group (0.57 %; 5 of 880) compared with the pre-intervention group (2.24 %; 25 of 1114). A corresponding risk reduction for PJI of 75.2 % (95 % CI of 35.2–90.5; p=0.004) was seen in the post-intervention group, which was most pronounced for early-onset and delayed infections due to coagulase-negative staphylococci (CoNS) and cefuroxime-resistant Enterobacteriaceae. Significantly higher AKI rates were seen in the post-intervention group; however, 84 % of cases (32 of 38) were stage 1, and there were no differences in the rate of stage-2 or -3 AKI. Conclusions: Teicoplanin plus gentamicin was associated with a significant reduction in PJI rates compared with cefuroxime. Increases in stage-1 AKI were seen with teicoplanin plus gentamicin.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"139 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136104295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should treatment decisions in septic arthritis of the native hip joint be based on the route of infection?","authors":"Fred Ruythooren, Stijn Ghijselings, Jordi Cools, Melissa Depypere, Paul De Munter, Willem-Jan Metsemakers, Georges Vles","doi":"10.5194/jbji-8-209-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-209-2023","url":null,"abstract":"Abstract. Background: Surgical management of septic arthritis (SA) of the hip aims at treating the infection by either preserving, resecting or replacing the joint. In some cases, joint preservation should be attempted, whereas other cases would benefit from immediate joint resection or replacement. Prognostic factors have been proposed to guide decision-making. We hypothesized that most of these factors can be simplified to three subgroups based on the route of infection: contiguous spreading, direct inoculation or hematogenous seeding. Methods: A total of 41 patients have been treated surgically for SA of the native hip at our tertiary hospital during the last 16 years. Medical records were studied, and various patient and disease characteristics were collated. Results: Significant differences between (1) level of fitness, (2) condition of the hip joint, (3) micro-organisms and (4) chance of femoral head preservation were found for patients with SA of the native hip resulting from the three aforementioned subgroups. Femoral head resection was necessary at one point in 85 % of patients. Patients with hematogenous infections of undamaged hips had a reasonable chance (53 %) of avoiding joint resection or replacement. Hip arthroplasty was performed on 46.3 % of patients, with an infection rate of 10.5 %. Conclusion: Patients with SA of the native hip resulting from contiguous spreading, hematogenous seeding or direct inoculation differ significantly and should be considered distinct clinical entities. Route of infection is directly related to the chance of femoral head preservation and should, therefore, guide decision-making. Only patients with hematogenous infection to a previously healthy hip had the possibility of femoral head preservation.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136013138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculous arthritis of native joints - a systematic review and European Bone and Joint Infection Society workgroup report.","authors":"Leonard C Marais,&nbsp;Luan Nieuwoudt,&nbsp;Adisha Nansook,&nbsp;Aditya Menon,&nbsp;Natividad Benito","doi":"10.5194/jbji-8-189-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-189-2023","url":null,"abstract":"<p><p><b>Introduction</b>: The aim of this systematic review was to assess the existing published data on the diagnosis and management of tuberculosis (TB) arthritis involving native joints in adults aged 18 years and older. <b>Methods</b>: This study was performed in accordance with the guidelines provided in the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). <b>Results</b>: The systematic review of the literature yielded 20 data sources involving 573 patients from nine countries. There was considerable variation amongst the studies in terms of the approach to diagnosis and management. The diagnosis was mostly made by microbiological tissue culture. Medical management involved a median of 12 months of anti-tubercular treatment (interquartile range, IQR, of 8-16; range of 4-18 months). The duration of preoperative treatment ranged from 2 to 12 weeks. Surgery was performed on 87 % of patients and varied from arthroscopic debridement to complete synovectomies combined with total joint arthroplasty. The mean follow-up time of all studies was 26 months (range of 3-112 months). Recurrence rates were reported in most studies, with an overall average recurrence rate of approximately 7.4 % (35 of 475 cases). <b>Conclusions</b>: The current literature on TB arthritis highlights the need for the establishment of standardized guidelines for the confirmation of the diagnosis. Further research is needed to define the optimal approach to medical and surgical treatment. The role of early debridement in active TB arthritis needs to be explored further. Specifically, comparative studies are required to address questions around the use of medical treatment alone vs. in combination with surgical intervention.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 4","pages":"189-207"},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41178950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A natural history of untreated chronic osteomyelitis of the tibia over 20 years, with evolving squamous cell carcinoma: a case report.","authors":"Asanka Wijendra,&nbsp;Alex Ramsden,&nbsp;Martin McNally","doi":"10.5194/jbji-8-183-2023","DOIUrl":"10.5194/jbji-8-183-2023","url":null,"abstract":"<p><p>Squamous cell carcinoma (SCC) is a rare but potentially life-threatening complication of chronic osteomyelitis. Whilst there have been over 100 cases of chronic osteomyelitis with malignant transformation reported in the literature between 1999 and 2020, this is the first case report to document transformation with 20 years of concordant imaging and clinical review.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 4","pages":"183-188"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41101728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dalbavancin is thermally stable at clinically relevant temperatures against methicillin-sensitive <i>Staphylococcus Aureus</i>.","authors":"Aaron K Hoyt, Patrick Lawler, Mathias Bostrom, Alberto V Carli, Ashley E Levack","doi":"10.5194/jbji-8-175-2023","DOIUrl":"10.5194/jbji-8-175-2023","url":null,"abstract":"<p><p><b>Introduction</b>: While the rate of orthopaedic infections has remained constant over the years, the burden on healthcare systems continues to rise with an aging population. Local antibiotic delivery via polymethyl methacrylate bone cement is a common adjunct in treating bone and joint infections. Dalbavancin is a novel lipoglycopeptide antibiotic in the same class as vancomycin that has shown efficacy against Gram-positive organisms when used systemically but has not been investigated as a local antibiotic. This study aims to identify whether dalbavancin is thermally stable at the temperatures expected during the polymerization of polymethyl methacrylate cement. <b>Methods</b>: Stock solutions of dalbavancin were prepared and heated using a polymerase chain reaction machine based upon previously defined models of curing temperatures in two clinically relevant models: a 10 mm polymethyl methacrylate bead and a polymethyl methacrylate articulating knee spacer model. Aliquots of heated dalbavancin were then transferred to be incubated at core body temperature (37 <math><msup><mi></mi><mo>∘</mo></msup></math>C) and analyzed at various time points up to 28 d. The minimum inhibitory concentration at which 90 % of colonies were inhibited (MIC<math><msub><mi></mi><mn>90</mn></msub></math>) for each heated sample was determined against methicillin-sensitive <i>Staphylococcus aureus</i> (American Type Culture Collection, ATCC, 0173K) using a standard microbroth dilution assay. <b>Results</b>: The average MIC<math><msub><mi></mi><mn>90</mn></msub></math> of dalbavancin was 1.63 <math><mrow><mi>µ</mi><mi>g</mi><mspace></mspace><msup><mi>mL</mi><mrow><mo>-</mo><mn>1</mn></mrow></msup></mrow></math> <math><mrow><mo>±</mo><mn>0.49</mn></mrow></math> against 0173K <i>S. aureus</i>. There were no significant differences in the relative MIC<math><msub><mi></mi><mn>90</mn></msub></math> values after heating dalbavancin in either model compared to unheated control dalbavancin. <b>Conclusions</b>: Dalbavancin is thermally stable at the curing temperatures of polymethyl methacrylate cement and at human core body temperature over 28 d. Future in vitro and in vivo studies are warranted to further investigate the role of dalbavancin as a local antibiotic prior to its clinical use.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 3","pages":"175-181"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41116764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}