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2.  Outcome and Predictors of Treatment Failure in Total Hip/Knee Prosthetic Joint Infections Due to Staphylococcus aureus 
The results of the present study suggest that ASA score ≤ 2 and use of rifampin-combination therapy are two independent factors associated with favorable outcome of patients treated for total hip or knee prosthetic infections due to S. aureus.
Background. Variables associated with the outcome of patients treated for prosthetic joint infections (PJIs) due to Staphylococcus aureus are not well known.
Methods. The medical records of patients treated surgically for total hip or knee prosthesis infection due to S. aureus were reviewed. Remission was defined by the absence of local or systemic signs of implant-related infection assessed during the most recent contact with the patient.
Results. After a mean posttreatment follow-up period of 43.6 ± 32.1 months, 77 (78.6%) of 98 patients were in remission. Retention of the infected implants was not associated with a worse outcome than was their removal. Methicillin-resistant S. aureus (MRSA)–related PJIs were not associated with worse outcome, compared with methicillin-susceptible S. aureus (MSSA)–related PJIs. Pathogens identified during revision for failure exhibited no acquired resistance to antibiotics used as definitive therapy, in particular rifampin. In univariate analysis, parameters that differed between patients whose treatment did or did not fail were: American Society of Anesthesiologists (ASA) score, prescription of adequate empirical postsurgical antibiotic therapy, and use of rifampin combination therapy upon discharge from hospital. In multivariate analysis, ASA score ≤2 (odds ratio [OR], 6.87 [95% confidence interval {CI}, 1.45–32.45]; P = .04) and rifampin-fluoroquinolone combination therapy (OR, 0.40 [95% CI, 0.17–0.97]; P = .01) were 2 independent variables associated with remission.
Conclusions. The results of the present study suggest that the ASA score significantly affects the outcome of patients treated for total hip and knee prosthetic infections due to MSSA or MRSA and that rifampin combination therapy is associated with a better outcome for these patients when compared with other antibiotic regimens.
doi:10.1093/cid/cir402
PMCID: PMC3148259  PMID: 21810745
3.  First Case of Postaneurysmal Prosthetic Vascular Infection Due to a Nonsuperantigenic Yersinia pseudotuberculosis Strain ▿  
Journal of Clinical Microbiology  2010;48(8):3024-3026.
Among Yersinia spp., Y. enterocolitica is the species most frequently isolated from infected aneurysms. This report describes the first case of postaneurysmal prosthetic vascular infection due to a superantigen-negative Yersinia pseudotuberculosis strain, showing a potential affinity of this species for endovascular tissue.
doi:10.1128/JCM.00671-10
PMCID: PMC2916569  PMID: 20573875
4.  First Case of Osteomyelitis Caused by “Staphylococcus pettenkoferi”▿  
Journal of Clinical Microbiology  2007;45(3):1069-1071.
“Staphylococcus pettenkoferi” (proposed name) was identified as an unusual agent of osteomyelitis in a diabetic foot infection. The phenotypical tests used failed to give a good identification. Molecular 16S rRNA gene and rpoB sequencing allowed us to correctly identify this new species of coagulase-negative staphylococcus responsible for this chronic infection.
doi:10.1128/JCM.02328-06
PMCID: PMC1829132  PMID: 17202276
5.  First Isolation of Clostridium amygdalinum from a Patient with Chronic Osteitis 
Journal of Clinical Microbiology  2006;44(10):3842-3844.
We describe a case of osteitis caused by a new and unusual Clostridium species, Clostridium amygdalinum, an environmental, moderately thermophilic bacterium. This is the first documented report of human infection caused by this organism.
doi:10.1128/JCM.01200-06
PMCID: PMC1594748  PMID: 17021125
6.  Performances of VITEK 2 Colorimetric Cards for Identification of Gram-Positive and Gram-Negative Bacteria 
Journal of Clinical Microbiology  2005;43(9):4402-4406.
Thepurpose of this study was to evaluate the new VITEK 2 identification cards that use colorimetric reading to identify gram-positive and gram-negative bacteria (GP and GN cards, respectively) in comparison to fluorimetric cards (ID-GPC and ID-GNB, respectively). A total of 580 clinical isolates and stock collection strains belonging to 116 taxa were included in the study. Of the 249 gram-positive strains tested with both the ID-GPC and GP cards, 218 (87.5%) and 235 (94.4%) strains were correctly identified (to the genus and species level), respectively. Of the 331 gram-negative strains tested with the ID-GNB and GN cards, 295 (89.1%) and 321 (97%) strains were correctly identified, respectively. Another focus of the study was to apply the percentages of correct identifications obtained in this study to the list of bacteria isolated in our laboratory (32,739 isolates) in the year 2004. We obtained 97.9% correct identifications with the colorimetric cards and 93.9% with fluorescent cards.
doi:10.1128/JCM.43.9.4402-4406.2005
PMCID: PMC1234120  PMID: 16145083
7.  Development and Use of an Internal Positive Control for Detection of Bordetella pertussis by PCR 
Journal of Clinical Microbiology  2005;43(5):2462-2464.
An internal control of amplification was constructed by recombinant PCR to detect PCR inhibitors. This exogenous DNA was included in the reaction mixture and coamplified with the target gene. This detection was successfully applied to the diagnosis of whooping cough by amplification of a fragment of Bordetella pertussis IS481.
doi:10.1128/JCM.43.5.2462-2464.2005
PMCID: PMC1153740  PMID: 15872283
8.  Detection of Yersinia pestis in Sputum by Real-Time PCR 
Journal of Clinical Microbiology  2003;41(10):4873-4875.
A 5′ nuclease PCR assay for detection of the Yersinia pestis plasminogen activator (pla) gene in human respiratory specimens with simulated Y. pestis infection was developed. An internal positive control was added to the reaction mixture in order to detect the presence of PCR inhibitors that are often found in biological samples. The assay was 100% specific for Y. pestis. In the absence of inhibitors, a sensitivity of 102 CFU/ml of respiratory fluid was obtained. When inhibitors were present, detection of Y. pestis DNA required a longer sample treatment time and an initial concentration of bacteria of at least 104 CFU/ml. The test's total turnaround time was less than 5 h. The assay described here is well suited to the rapid diagnosis of pneumonic plague, the form of plague most likely to result from a bioterrorist attack.
doi:10.1128/JCM.41.10.4873-4875.2003
PMCID: PMC254301  PMID: 14532247

Results 1-8 (8)