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Antibiotics
Special Issues
Diagnostics and Antibiotic Therapy in Bone and Joint Infections
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Diagnostics and Antibiotic Therapy in Bone and Joint Infections

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 1263

Special Issue Editors

Dr. Sebastian Meller

E-Mail Website
Guest Editor
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany
Interests: periprosthetic joint infection (pji); revision arthroplasty; local antibiotic carriers; one-stage and two-stage exchange; biofilm and implant-associated infection; musculoskeletal infection; hip surgery; knee surgery
Dr. Stavros Goumenos

E-Mail Website
Guest Editor
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany
Interests: Bone and joint infections (BJI); arthroplasty; osteomyelitis; immune responses to BJI; antibiotics

Special Issue Information

Dear Colleagues,

We are pleased to announce the forthcoming Special Issue of Antibiotics, titled “Diagnostics and Antibiotic Therapy in Bone and Joint Infections”.

Bone and joint infections represent a complex clinical challenge, often requiring timely diagnosis and multidisciplinary management to ensure optimal clinical and functional outcomes. Despite advances in imaging, microbiology, surgical techniques, and antimicrobial stewardship, significant gaps remain in our understanding and standardization of diagnostic and therapeutic approaches.

This Special Issue aims to bring together high-quality original research (clinical or experimental) and comprehensive reviews that explore current trends, innovative diagnostic tools, surgical strategies, and evolving antibiotic regimens in the management of osteomyelitis, implant-related infections, and other musculoskeletal infections.

We warmly invite researchers, clinicians, microbiologists, and infectious disease specialists to contribute their relevant work to this issue. Submissions addressing novel biomarkers, rapid diagnostic techniques, biofilm-related challenges, antibiotic resistance, the use of new local antimicrobial carriers, and alternative treatment algorithms for bone and joint infections are particularly encouraged.

We look forward to hearing from you.

Dr. Sebastian Meller
Dr. Stavros Goumenos
Guest Editors

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 250 words) can be sent to the Editorial Office for assessment.

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

  • bone and joint infections
  • osteomyelitis
  • implant-related infections
  • diagnostics
  • antimicrobials
  • antibiotic therapy
  • PJI management
  • surgical site antisepsis
  • local antibiotic therapy
  • diagnostic biomarkers
  • multidisciplinary infection management
  • outcome analysis after musculoskeletal infection

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

15 pages, 1753 KB  
Article
Exploring the Value of Paired Microbiology and Histology in Chronic Osteomyelitis and Fracture-Related Infections
by Anton A. N. Peterlin, Martin McNally, Nicole L. Henriksen, Sophie A. Blirup-Plum, Ann Jørgensen, Andreas Ibrahim Jørgensen, Inger Brock, Hans Gottlieb and Louise K. Jensen
Antibiotics 2025, 14(12), 1277; https://doi.org/10.3390/antibiotics14121277 - 16 Dec 2025
Viewed by 162
Abstract
Background: Microbiological culture and histology are gold standards for diagnosing chronic osteomyelitis (cOM) and fracture-related infection (FRI). This study investigated whether combining these modalities within a single tissue sample provides additional insight into disease severity. We hypothesized that high neutrophil and osteoclast [...] Read more.
Background: Microbiological culture and histology are gold standards for diagnosing chronic osteomyelitis (cOM) and fracture-related infection (FRI). This study investigated whether combining these modalities within a single tissue sample provides additional insight into disease severity. We hypothesized that high neutrophil and osteoclast numbers correlate with culture-positive microbiology and that double-positive samples may indicate more severe disease. Methods: In this prospective single-centre study, adults undergoing surgery for confirmed FRI or cOM were included. Clinical and disease classification data (FRI and BACH) were recorded. Five deep-tissue samples were collected intraoperatively and divided for paired microbiological culture and histological assessment of neutrophil infiltration, according to international diagnostic guidelines. Results: Forty-one patients were included (11 cOM, 30 FRI) of whom 68% received preoperative antibiotics. Nineteen patients (46%) were identified as culture-positive, while 32 patients (78%) were histologically positive according to international diagnostic guidelines, respectively. Among the 205 samples, 31% were culture-positive, 56% histology-positive, and 26% double-positive. Histological scores were significantly higher in culture-positive samples (p < 0.001). Treatment failure occurred in seven patients (18%), all with FRI. Paired positive samples were associated with increased odds of clinical failure and earlier revision, with odds increasing 1.68-fold for each additional paired positive sample (95% CI, 1.10–2.77). Conclusions: The paired analysis demonstrated a strong concordance between culture-positivity and suppurative inflammation within the same sample. Combining microbiology and histology may help identify patients at increased risk of revision and enhance diagnostic certainty, particularly in patients identified as culture-negative. Full article
(This article belongs to the Special Issue Diagnostics and Antibiotic Therapy in Bone and Joint Infections)
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12 pages, 483 KB  
Article
Local Vancomycin Application Reduces Periprosthetic Joint Infections in Oncologic Megaprosthetic Reconstruction: A Retrospective Cohort Study
by Andreas G. Tsantes, Dimitrios V. Papadopoulos, Stavros Goumenos, Petros Ioannou, Nikolaos Stavropoulos, Eleni Petrou, Ioannis G. Trikoupis, Christos Koutserimpas, Alexandra Mpakosi, Vasileios A. Kontogeorgakos, Stefanos Bonovas, Panayiotis J. Papagelopoulos, Athanasios Tsakris and Argirios E. Tsantes
Antibiotics 2025, 14(9), 952; https://doi.org/10.3390/antibiotics14090952 - 19 Sep 2025
Viewed by 822
Abstract
Background/Objectives: Periprosthetic joint infections (PJIs) represent a serious complication following musculoskeletal tumor resection and megaprosthetic reconstruction. Local antibiotic administration may reduce infection risk by achieving high local drug concentrations. The aim of this study was to evaluate whether local vancomycin powder reduces postoperative [...] Read more.
Background/Objectives: Periprosthetic joint infections (PJIs) represent a serious complication following musculoskeletal tumor resection and megaprosthetic reconstruction. Local antibiotic administration may reduce infection risk by achieving high local drug concentrations. The aim of this study was to evaluate whether local vancomycin powder reduces postoperative periprosthetic infections in bone tumor surgeries involving megaprostheses. Methods: This retrospective cohort study included 276 patients who underwent bone tumor resection and megaprosthetic reconstruction. Study subjects were divided into two groups: the control group (n = 142) that received standard perioperative intravenous antibiotics, and the vancomycin group (n = 134) that received an additional 1 g of vancomycin powder locally at wound closure. Periprosthetic joint infections were defined using the 2018 International Consensus Meeting (ICM) criteria and monitored for 2 years. A multivariable competing risks regression model was used to assess the independent effect of local vancomycin on infection risk. Results: Periprosthetic joint infections occurred in 28 patients in the control group (19.7%) vs. eight patients in the vancomycin group (5.9%, p = 0.001). The most frequently isolated pathogens were coagulase-negative staphylococci (52.7%), followed by Staphylococcus aureus (22.2%). Among infected patients in the vancomycin group, only two had Gram-positive infections, suggesting efficacy against staphylococcal PJIs. The multivariable regression confirmed a significantly lower risk of infection in the vancomycin group (hazard ratio [HR]: 0.40, 95% confidence interval [CI]: 0.16–0.95, p = 0.040), while pelvic tumors were associated with a higher infection risk (HR: 5.82, p < 0.001). Conclusions: Our results indicate that local vancomycin may reduce periprosthetic infection rates in oncologic megaprosthetic reconstruction without added complications. Randomized studies are warranted to confirm these findings and refine dosing strategies. Full article
(This article belongs to the Special Issue Diagnostics and Antibiotic Therapy in Bone and Joint Infections)
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