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Antibiotics
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Orthopedic Infections: Epidemiology and Antimicrobial Treatment
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Orthopedic Infections: Epidemiology and Antimicrobial Treatment

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: 28 February 2025 | Viewed by 3379

Special Issue Editor

Dr. Éric Bonnet

E-Mail Website
Guest Editor
Purpan University Hospital, 31300 Toulouse, France
Interests: orthopedic infections; cardio-vascular infections; new antimicrobials; antimicrobial prophylaxis; antimicrobial Stewardship

Special Issue Information

Dear Colleagues,

Orthopedic infections remain challenging to treat and sometimes difficult to diagnose. Their management requires a multidisciplinary approach. They include post-surgical osteomyelitis, prosthetic joint infections, and various infections, such as septic arthritis after ligament reconstructions. This Special Issue will focus on these infections and describe the epidemiology, including infection rates, risk factors, and microbiology. Then, we will discuss antimicrobial treatment, focusing on probabilistic treatment options, therapy of documented infections, when to use anti-biofilm antibiotics, particularly rifampicin, when to use a combination of antibiotics, the total duration of treatment and duration of IV (if needed) treatment, the place of local antimicrobial agents and new systemic antibiotics.

Dr. Éric Bonnet
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic osteomyelitis
  • prosthetic joint infections
  • epidemiology
  • microbiology
  • antimicrobial treatment
  • treatment duration
  • local antibiotics

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Published Papers (3 papers)

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Research

10 pages, 551 KiB  
Article
Microbiological Profile of Instrumented Spinal Infections: 10-Year Study at a French Spine Center
by Sophie Reissier, Carine Couzigou, Romain Courseau, Elise Aubert, Alban Le Monnier, Eric Bonnet, Peter Upex, Pierre-Emmanuel Moreau, Guillaume Riouallon and Julie Lourtet-Hascoët
Antibiotics 2024, 13(9), 791; https://doi.org/10.3390/antibiotics13090791 - 23 Aug 2024
Viewed by 559
Abstract
Objective: The objective was to compare the microbiological characteristics and treatment of early and late surgical site infections (SSIs) in instrumented spinal surgery. Methods: Those patients admitted for SSIs in a single center between January 2010 and December 2022 were included. The subjects [...] Read more.
Objective: The objective was to compare the microbiological characteristics and treatment of early and late surgical site infections (SSIs) in instrumented spinal surgery. Methods: Those patients admitted for SSIs in a single center between January 2010 and December 2022 were included. The subjects were divided into early (eSSIs) and late (lSSIs) SSIs, and demographic, microbiological, treatment, and follow-up data were collected. Results: Instrumented spinal surgery was performed in 2136 patients. Ninety-six cases of infections were identified (prevalence = 4.5%), with 47.9% eSSIs and 52.1% lSSIs. In 58.7% of the cases, the eSSIs were monomicrobial: Staphylococcus aureus (37%) and Enterobacterales (33.3%) were the main bacteria involved. In 66% of the cases, the lSSIs, were monomicrobial: Cutibacterium acnes (30.3%) and staphylococci were predominant. Enterobacterales were isolated in more than 70% of the polymicrobial samples in both the eSSIs and lSSIs. The treatment of the eSSIs mostly consisted of lavage-debridement surgery associated with antibiotic treatment, while the treatment of the lSSIs combined hardware removal or replacement and long-duration antibiotic treatment. A negative outcome was observed in 17.1% of the eSSIs and 5.7% of the lSSIs. Enterobacterales were associated with negative outcomes of eSSIs. Conclusions: Enterobacterales were found in most of the polymicrobial infections regardless of the time of infection onset. Further large studies should be conducted to precisely determine the management and prevention regarding the increasing Gram-negative bacteria SSIs. Full article
(This article belongs to the Special Issue Orthopedic Infections: Epidemiology and Antimicrobial Treatment)
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14 pages, 1904 KiB  
Article
Local Antimicrobial Therapy with Combined Aminoglycoside and Vancomycin Compared to Aminoglycoside Monotherapy in the Surgical Management of Osteomyelitis and Fracture-Related Infection
by Annalise Unsworth, Bernadette Young, Jamie Ferguson, Matthew Scarborough and Martin McNally
Antibiotics 2024, 13(8), 703; https://doi.org/10.3390/antibiotics13080703 - 27 Jul 2024
Cited by 1 | Viewed by 1134
Abstract
We investigated the effect of combination aminoglycoside and vancomycin local antibiotic treatment compared to aminoglycoside alone in the surgical management of bone infection. Data including patient demographics, type of surgery, microbiological characteristics, BACH score, duration of antibiotic treatment and clinical outcomes were collected. [...] Read more.
We investigated the effect of combination aminoglycoside and vancomycin local antibiotic treatment compared to aminoglycoside alone in the surgical management of bone infection. Data including patient demographics, type of surgery, microbiological characteristics, BACH score, duration of antibiotic treatment and clinical outcomes were collected. Failure of therapy was a composite of recurrence of infection, continued or new antimicrobial therapy, or reoperation with suspected or confirmed infection at one year after index surgery. A total of 266 patients met the inclusion criteria. 252 patients reached the final follow-up and were included in the final analysis. 113 patients had treatment with aminoglycoside alone and 139 patients had combination aminoglycoside and vancomycin. There was no difference in the failure rate between groups; 10/113 (8.8%) in the aminoglycoside alone and 12/139 (8.6%) in the combination group, p = 0.934. Multivariate analysis showed that there was no added benefit of combination therapy (OR 1.54: 95% CI 0.59–4.04, p = 0.38). BACH score and low BMI were associated with increased risk of failure (BACH OR 3.49: 95% CI 1.13–10.76, p = 0.03; Low BMI OR 0.91: 95% CI 0.84–0.99, p = 0.037). The form of the carrier material (pellets or injectable paste) had no effect on failure rate (p = 0.163). The presence of aminoglycoside resistance had no effect on failure rate (OR 0.39: 95% CI 0.05–3.01, p = 0.37). Clinical outcome was not improved by the addition of vancomycin to aminoglycoside alone as local therapy for the management of bone infection. Full article
(This article belongs to the Special Issue Orthopedic Infections: Epidemiology and Antimicrobial Treatment)
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10 pages, 795 KiB  
Article
What Place Is There for Long-Acting Antibiotics in the Management of Gram-Positive Infections? A Qualitative Cross-Sectional Study
by Aurélien Dinh, Guillaume Béraud, Johan Courjon, Yann Le Goff, Nicolas Kader Ettahar, Matthieu Grégoire and Eric Senneville
Antibiotics 2024, 13(7), 644; https://doi.org/10.3390/antibiotics13070644 - 12 Jul 2024
Viewed by 1213
Abstract
Objectives. To identify the current practices with long half-life lipoglycopeptides (LGPs) and potential use/position of oritavancin. Results. Despite their indication being limited to skin and soft tissue infections (SSTIs), long half-life lipoglycopeptides are mainly used off-label to treat bone and joint infections (BJIs) [...] Read more.
Objectives. To identify the current practices with long half-life lipoglycopeptides (LGPs) and potential use/position of oritavancin. Results. Despite their indication being limited to skin and soft tissue infections (SSTIs), long half-life lipoglycopeptides are mainly used off-label to treat bone and joint infections (BJIs) and infective endocarditis. Oritavancin and dalbavancin are both semisynthetic lipoglycopeptide antibiotics with activity against Gram-positive organisms. The game-changing property of these two antibiotics is their one-time dosing. Due to its shorter half-life, oritavancin might have an advantage over dalbavancin for a treatment duration of less than 2 weeks, as it could be used both in prolonged treatments of complicated patients in BJIs or administered as a single-dose treatment for Gram-positive cocci infections usually treated by a 5- to 10-day antibiotic course. These infections include urinary tract infections, bacteremias, catheter-related infections, etc. In addition to the possibility of being used as an end-of-treatment injection, oritavancin could be used as an empiric therapy treatment in the postoperative period in the context of device-associated especially prosthetic joint infections to allow for the early discharge of the patient. Methods. A qualitative survey was conducted in March 2022 including sixteen infectiologists, one internist, five hospital pharmacists, and one pharmacologist. Conclusion. Long half-life lipoglycopeptides contribute to changing the paradigm in the management of acute bacterial infections, as infectiologists now consider a range of indications and patient profiles for one single drug. Oritavancin strengthens the therapeutic arsenal in numerous infections from BJIs to urinary tract infections and could help to manage specific clinical situations, on top of providing potential benefits for the hospital’s budget. Full article
(This article belongs to the Special Issue Orthopedic Infections: Epidemiology and Antimicrobial Treatment)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Local Antimicrobial Therapy with Combined Gentamicin and Vancomycin compared to Gentamicin Monotherapy in the Management of Bone Infection

Martin McNally

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