Bone and joint infections of the hand.

Anti-Bacterial Agents / therapeutic use Arthritis, Infectious / diagnosis Combined Modality Therapy Early Diagnosis Female Hand Bones / drug effects Hand Joints / drug effects Humans Male Osteomyelitis / diagnosis Practice Guidelines as Topic Randomized Controlled Trials as Topic Standard of Care
Bone and joint infections Finger joint infection Hand infection Osteomyelitis Septic arthritis

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:
Jul 2020
Historique:
received: 10 10 2019
revised: 10 12 2019
accepted: 14 12 2019
pubmed: 10 1 2020
medline: 29 1 2021
entrez: 10 1 2020
Statut: ppublish

Résumé

Little guidance is currently available for standardized diagnostic protocols and therapeutic recommendations for bone and joint infections (BJIs) of the hand. To summarize the available data in the scientific English-language literature on the diagnosis and treatment of native BJIs of the hand. To illustrate these concepts from a narrative point of view in areas where there is lack of evidence. We performed a systematic PubMed and Internet search of studies that investigated hand BJIs in adult patients. Few studies have systematically investigated and validated diagnostic concepts, classifications or surgical treatment protocols. Most concepts derive from traditional intra-institutional experience, expert opinions and extrapolations from infections in large joints and long bones. Similarly, there is no uniformly accepted infection definition of BJIs of the hand. The best-documented literature is available for microbiological findings and antibiotic treatment duration in uncomplicated native joint arthritis of the fingers. Retrospective studies and one prospective randomized trial suggest that post-surgical targeted antibiotic therapy of 2 weeks results in a microbiological cure rate of ≥88%. Studies on diagnostic workup and infection definition and classification are urgently needed to compare inter-institutional outcome results and generate guidelines for the best patient care. For uncomplicated pyogenic arthritis of native joints, current evidence suggests that a 2-week course of antibiotic therapy following surgery cures the infection.

Sections du résumé

BACKGROUND BACKGROUND
Little guidance is currently available for standardized diagnostic protocols and therapeutic recommendations for bone and joint infections (BJIs) of the hand.
OBJECTIVES OBJECTIVE
To summarize the available data in the scientific English-language literature on the diagnosis and treatment of native BJIs of the hand. To illustrate these concepts from a narrative point of view in areas where there is lack of evidence.
SOURCES METHODS
We performed a systematic PubMed and Internet search of studies that investigated hand BJIs in adult patients.
CONTENT BACKGROUND
Few studies have systematically investigated and validated diagnostic concepts, classifications or surgical treatment protocols. Most concepts derive from traditional intra-institutional experience, expert opinions and extrapolations from infections in large joints and long bones. Similarly, there is no uniformly accepted infection definition of BJIs of the hand. The best-documented literature is available for microbiological findings and antibiotic treatment duration in uncomplicated native joint arthritis of the fingers. Retrospective studies and one prospective randomized trial suggest that post-surgical targeted antibiotic therapy of 2 weeks results in a microbiological cure rate of ≥88%.
IMPLICATIONS CONCLUSIONS
Studies on diagnostic workup and infection definition and classification are urgently needed to compare inter-institutional outcome results and generate guidelines for the best patient care. For uncomplicated pyogenic arthritis of native joints, current evidence suggests that a 2-week course of antibiotic therapy following surgery cures the infection.

Identifiants

DOI: 10.1016/j.cmi.2019.12.007 PMID: 31917233
pubmed: 31917233
pii: S1198-743X(19)30659-7
doi: 10.1016/j.cmi.2019.12.007
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

848-856

Informations de copyright

Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Auteurs

P Sendi (P)

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, University of Basel, Switzerland; Institute of Infectious Diseases, University of Bern, Bern, Switzerland. Electronic address: parham.sendi@ifik.unibe.ch.

A Kaempfen (A)

Clinic for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland.

I Uçkay (I)

Infectiology, Balgrist University Hospital, Zürich, Switzerland.

R Meier (R)

Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Bone and joint infections of the hand.
questionsmedicales.fr › Maladies ostéomusculaires › Maladies articulaires › Arthrite › Arthrite infectieuse › Bone and joint infections of the hand.
questionsmedicales.fr › Thérapeutique › Association thérapeutique › Bone and joint infections of the hand.
questionsmedicales.fr › Diagnostic › Diagnostic précoce › Bone and joint infections of the hand.
questionsmedicales.fr › Appareil locomoteur › Squelette › Os du membre supérieur › Os de la main › Bone and joint infections of the hand.
questionsmedicales.fr › Appareil locomoteur › Squelette › Articulations › Articulations de la main › Bone and joint infections of the hand.
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Bone and joint infections of the hand.
questionsmedicales.fr › Maladies ostéomusculaires › Maladies osseuses › Infections osseuses › Ostéomyélite › Bone and joint infections of the hand.
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Assurance de la qualité des soins de santé › Recommandations comme sujet › Guides de bonnes pratiques cliniques comme sujet › Bone and joint infections of the hand.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › Bone and joint infections of the hand.
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Norme de soins › Bone and joint infections of the hand.