Pathogenesis and management of fracture-related infection.


Journal

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420

Informations de publication

Date de publication:
May 2020
Historique:
received: 23 05 2019
revised: 09 08 2019
accepted: 10 08 2019
pubmed: 26 8 2019
medline: 5 1 2021
entrez: 26 8 2019
Statut: ppublish

Résumé

Both fracture-related infections (FRIs) and periprosthetic joint infections (PJIs) include orthopaedic implant-associated infections. However, key aspects of management differ due to the bone and soft tissue damage in FRIs and the option of removing the implant after fracture healing. In contrast to PJIs, research and guidelines for diagnosis and treatment in FRIs are scarce. This narrative review aims to update clinical microbiologists, infectious disease specialists and surgeons on the management of FRIs. A computerized search of PubMed was performed to identify relevant studies. Search terms included 'Fracture' and 'Infection'. The reference lists of all retrieved articles were checked for additional relevant references. In addition, when scientific evidence was lacking, recommendations are based on expert opinion. Pathogenesis, prevention, diagnosis and treatment of FRIs are presented. Whenever available, specific data of patients with FRI are discussed. Management of patients with FRI should take into account FRI-specific features. Treatment pathways should implement a multidisciplinary approach to achieve a good outcome. Recently, international consensus guidelines were developed to improve the quality of care for patients suffering from this severe complication, which are highlighted in this review.

Sections du résumé

BACKGROUND BACKGROUND
Both fracture-related infections (FRIs) and periprosthetic joint infections (PJIs) include orthopaedic implant-associated infections. However, key aspects of management differ due to the bone and soft tissue damage in FRIs and the option of removing the implant after fracture healing. In contrast to PJIs, research and guidelines for diagnosis and treatment in FRIs are scarce.
OBJECTIVES OBJECTIVE
This narrative review aims to update clinical microbiologists, infectious disease specialists and surgeons on the management of FRIs.
SOURCES METHODS
A computerized search of PubMed was performed to identify relevant studies. Search terms included 'Fracture' and 'Infection'. The reference lists of all retrieved articles were checked for additional relevant references. In addition, when scientific evidence was lacking, recommendations are based on expert opinion.
CONTENT BACKGROUND
Pathogenesis, prevention, diagnosis and treatment of FRIs are presented. Whenever available, specific data of patients with FRI are discussed.
IMPLICATIONS CONCLUSIONS
Management of patients with FRI should take into account FRI-specific features. Treatment pathways should implement a multidisciplinary approach to achieve a good outcome. Recently, international consensus guidelines were developed to improve the quality of care for patients suffering from this severe complication, which are highlighted in this review.

Identifiants

pubmed: 31446152
pii: S1198-743X(19)30447-1
doi: 10.1016/j.cmi.2019.08.006
pii:
doi:

Substances chimiques

Biomarkers 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

572-578

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Auteurs

M Depypere (M)

Department of Laboratory Medicine, University Hospitals Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Belgium. Electronic address: melissa.depypere@uzleuven.be.

M Morgenstern (M)

Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Switzerland.

R Kuehl (R)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Switzerland.

E Senneville (E)

Department of Infectious Diseases, Gustave Dron Hospital, University of Lille, Lille, France.

T F Moriarty (TF)

AO Research Institute, Davos, Switzerland.

W T Obremskey (WT)

Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.

W Zimmerli (W)

Interdisciplinary Unit for Orthopaedic Infections, Kantonsspital Baselland, Liestal, Switzerland.

A Trampuz (A)

Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Centre for Musculoskeletal Surgery, Berlin, Germany.

K Lagrou (K)

Department of Laboratory Medicine, University Hospitals Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.

W-J Metsemakers (WJ)

Department of Trauma Surgery, University Hospitals Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Belgium.

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