Les centres de référence des infections ostéoarticulaires (CRIOAC) en France

Bone and joint infections (BJI) are rare but have a high morbidity and economic burden. The complexity of these infections is the consequence of their heterogeneous clinical presentation and is responsible for significant heterogeneity in their management. Risk factors for failure were identified based on the analysis of pre-existing registries and led to the emergence of a new definition : Complex-BJI. This definition has allowed a better categorization of these infections and the targeting of those with a more serious vital and functional prognosis and a high economic impact. In order to offer a homogeneous and optimal management of these infections, the need for a multidisciplinary expertise became apparent and the Ministry of Health, supported by the healthcare societies, set up a national network of referral centers for complex bone and joint infections in 2008. These centers have been implemented sequentially throughout the French territory and, currently, 9 reference centers and 21 associate centers were certified. Their role are: 1) to provide advice on the management of BJI at a local and regional level and especially for Complex-BJI through periodic multidisciplinary meetings involving at least an infectious diseases specialist, an orthopedic surgeon and a microbiologist; 2) to organize learning sessions for BJI management with the creation of a postgraduate diploma and the organization of a national scientific meetings focused on these infections; 3) to promote clinical research and technological development by conducting national-wide clinical trials and epidemiological analysis based on the data from multidisciplinary meetings recorded in a national registry.