Liste des références et résumés des publications de l’équipe de LILLE TOURCOING consacrées à l’infection ostéo-articulaire dans des revues référencées sur PubMed
PUBLICATIONS INTERNATIONALES
1) SENNEVILLE E., YAZDANPANAH Y., CAZAUBIEL M., CORDONNIER M., VALETTE M., et al. Rifampicin-ofloxacin oral regimen for the treatment of mild to moderate diabetic foot osteomyelitis. J Antimicrob Chemother 2001 ; 48 : 927-30.
Seventeen diabetic patients with moderate to mild foot lesions associated with 20 osteomyelitic bones diagnosed by both bone scan and bone biopsy received rifampicin plus ofloxacin for a median duration of 6 months. Cure was defined as disappearance of all signs and symptoms of infection at the end of the treatment and absence of relapse during follow up. At the end of the treatment period, cure was achieved in 15 patients (88.2%) and was maintained in 13 patients (76.5%) at the end of an average post-treatment follow-up of 22 months. No serious drug-related adverse events were recorded.
PMID: 11733482 [PubMed - indexed for MEDLINE]
2) SENNEVILLE E, LEGOUT L, VALETTE M, YAZDANPANAH Y, GIRAUD F, BELTRAND E, ET AL. Risk factors for anaemia in patients on prolonged linezolid therapy for chronic osteomyelitis: a case-control study. J Antimicrob Chemother. 2004 Oct;54 (4): 798-802.
OBJECTIVES: The intrinsic properties of the new antibiotic linezolid make it an attractive candidate for the treatment of chronic osteomyelitis. However, data regarding the tolerance of long-term linezolid administration are still lacking. METHODS: The medical charts of patients given linezolid for >4 weeks were retrospectively analysed, especially their haematology. In a case-control study, we compared the respective characteristics of patients who developed anaemia during linezolid therapy and those who did not. RESULTS: Forty-five adults with chronic osteomyelitis received 600 mg linezolid intravenously twice daily for 7 days, and then orally, for a mean total duration of 15.9 weeks (range, 6-36). Anaemia episodes requiring blood transfusion occurred in 13/45 patients (28.9%). Median time from treatment initiation to anaemia onset was 7.4 weeks (range, 4-16). Anaemia was significantly associated with premature linezolid therapy cessation (P = 0.0012). No linezolid-related thrombocytopenia was observed. By univariate analysis, four variables were associated with the occurrence of anaemia: age >58 years, alcohol abuse, diabetes mellitus and low haemoglobin before linezolid treatment. Logistic regression analysis revealed two independent risk factors for anaemia: age >58 years (OR = 20.5, 95% CI 0.69-599; P = 0.0001) and pre-treatment haemoglobin <10.5 g/dL (OR = 16.49, 95% CI 1.06-255; P = 0.04). CONCLUSIONS: Profound anaemia may occur in adult patients with chronic osteomyelitis on prolonged linezolid therapy, and often necessitates linezolid cessation. These patients are likely to be aged >58 years and to have low pre-treatment haemoglobin. The results for the present series might help physicians to identify patients who should not be given long-term linezolid treatment for chronic osteomyelitis.
PMID: 15329363 [PubMed - indexed for MEDLINE]
3) SENNEVILLE E. Antimicrobial interventions for the management of diabetic foot infections. Expert Opin. Pharmacother. 2005; 6 (2): 263-273.
Foot infections are the most common cause of hospitalisations and amputations in diabetic patients. They occur after skin ulcers or trauma in patients with peripheral neuropathy, sometimes together with vascular disease. Narrow-spectrum antibiotic agents should be prescribed for minor recent infections, and broader-spectrum agents for severe or chronic infections. When indicated, antibiotic therapy should be started early and be tailored to the individual patient. Diabetic foot osteomyelitis is a particularly controversial condition, especially regarding the need for reliable cultures, the type and duration of treatment, and the role of surgery. Recent data indicates that a medical approach might be effective and could reduce foot amputations among diabetic patients. Interdisciplinary cooperation with infectious disease specialists and orthopaedic surgeons should be considered in such situations.
PMID: 15757422 [PubMed - indexed for MEDLINE]
4) CHANTELOT C., CHANTELOT-LAHOUDE S., MASMEJEAN E., EDDINE TA., MIGAUD H., FONTAINE C. Reconstruction of the distal humeral metaphysis by a free vascularized fibular autograft. A case report. J Shoulder Elbow Surg, 2005, 14, 450-453.
PMID: 16015249 [PubMed – indexed for MEDLINE]
5) SENNEVILLE E, MELLIEZ H, BELTRAND E, LEGOUT L, VALETTE M, CAZAUBIEL M, CORDONNIER M, CAILLAUX M, YAZDANPANAH Y, MOUTON Y. Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: concordance with ulcer swab cultures. Clin Infect Dis. 2006 Jan 1;42(1):57-62.
BACKGROUND: We assessed the diagnostic value of swab cultures by comparing them with corresponding cultures of percutaneous bone biopsy specimens for patients with diabetic foot osteomyelitis. METHODS: The medical charts of patients with foot osteomyelitis who underwent a surgical percutaneous bone biopsy between January 1996 and June 2004 in a single diabetic foot clinic were reviewed. Seventy-six patients with 81 episodes of foot osteomyelitis who had positive results of culture of bone biopsy specimens and who had received no antibiotic therapy for at least 4 weeks before biopsy constituted the study population. RESULTS: Pathogens isolated from bone samples were predominantly staphylococci (52%) and gram-negative bacilli (18.4%). The distributions of microorganisms in bone and swab cultures were similar, except for coagulase-negative staphylococci, which were more prevalent in bone samples (P < .001). The results for cultures of concomitant foot ulcer swabs were available for 69 of 76 patients. The results of bone and swab cultures were identical for 12 (17.4%) of 69 patients, and bone bacteria were isolated from the corresponding swab culture in 21 (30.4%) of 69 patients. The concordance between the results of cultures of swab and of bone biopsy specimens was 42.8% for Staphylococcus aureus, 28.5% for gram-negative bacilli, and 25.8% for streptococci. The overall concordance for all isolates was 22.5%. No adverse events--such as worsening peripheral vascular disease, fracture, or biopsy-induced bone infection--were observed, but 1 patient experienced an episode of acute Charcot osteoarthropathy 4 weeks after bone biopsy was performed. CONCLUSIONS: These results suggest that superficial swab cultures do not reliably identify bone bacteria. Percutaneous bone biopsy seems to be safe for patients with diabetic foot osteomyelitis.
PMID: 16323092 [PubMed - indexed for MEDLINE]
6) SENNEVILLE E, SAVAGE C, NALLET I, YAZDANPANAH Y, GIRAUD F, MIGAUD H, DUBREUIL L, COURCOL R, MOUTON Y. Improved aero-anaerobe recovery from infected prosthetic joint samples taken from 72 patients and collected intraoperatively in Rosenow's broth. Acta Orthop. 2006 Feb ;77(1):120-4.
INTRODUCTION: Recovery of the bacteria responsible for prosthetic joint infections is a major problem, which is due in part to the alteration of their ability to grow by storage during transportation to the laboratory. METHODS: In this prospective study, we assessed the benefit of inoculating an enriched liquid medium (Rosenow's broth) with intraoperative samples from 72 patients with prosthetic joint revision due to infection. We compared the results of culture of specimens collected in a standard receptacle with the results for specimens collected in Rosenow's broth. RESULTS AND INTERPRETATION: 144 samples were taken by each of the 2 collection methods for subsequent culture. Concordance between standard and Rosenow samples was observed for 52 of the 58 strains cultured on agar and for 42 of the 97 strains (p < 0.001) which grew only in liquid medium. Infection would not have been diagnosed in 26 patients (almost one-third of all patients) without combining sample collection in Rosenow's broth with standard collection. The bacteria that were not recovered from standard samples but which were recovered from those collected in Rosenow's broth included not only strict anaerobes, in particular Propionibacterium acnes, but also coagulase-negative staphylococci and streptococci.
PMID: 16534711 [PubMed - indexed for MEDLINE]
7) SENNEVILLE E, LEGOUT L, VALETTE M, YAZDANPANAH Y, BELTRAND E, CAILLAUX M, MIGAUD H, MOUTON Y. Effectiveness and tolerability of prolonged linezolid treatment for chronic osteomyelitis: a retrospective study. Clin Ther. 2006; 28:1155-63.
BACKGROUND: Linezolid is an oxazolidinone agent which is apparently well designed for treating chronic osteomyelitis, but data on effectiveness and tolerability as prolonged therapy is currently lacking. OBJECTIVE: The purpose of this study was to assess the effectiveness and tolerability of linezolid in the treatment of chronic osteomyelitis. METHODS: The charts of hospitalized patients who had been treated with linezolid for >4 weeks because of chronic osteomyelitis and were followed up for > or =12 months after the end of treatment were retrospectively reviewed for clinical outcome and tolerability. Cure was defined as the absence of clinical, biological, or radiological evidence of infection throughout the posttreatment follow-up. Linezolid tolerability was assessed on the basis of hematologic properties during treatment. RESULTS: Of the 66 patients included, all were white (mean [SD] age, 67.7 [18.1] years; 41 men and 25 women; mean [SD] weight, 80.7 [18.6] kg). Thirty-seven (56.1%) patients had infection due to implants including 27 prosthetic joints. Pathogens were predominantly methicillin-resistant staphylococci (49/72 strains, 68.1 %). Every patient was administered N linezolid (600 mg BID) treatment for 6 to 8 days as inpatients, and then, as outpatients, they were switched to PO treatment. Fifty (75.8%) patients received a combination of linezolid and other antimicrobial agents, including rifampin (32 [48.5%]). Surgery was performed in 52 (78.8%) patients. The median hospital stay was 14 days (mean [SD], 19 [11.4] days [range, 7-70 days] ). The median duration of treatment was 13 weeks (mean [SD], 14.3 [8.2] weeks [range, 5-36 weeks]). At the end of treatment, 56 (84.8%) patients were cured, and during the post-treatment follow-up (median duration, 15 months [range, 12-36 months]), 4 relapses occurred, resulting in an overall successful cure for 52 (78.8%) patients. Reversible anemia was reported in 21 patients (31.8%), of whom 16 (24.2%) required blood transfusions. Median time from treatment initiation to anemia onset was 7.3 weeks (range, 4-12 weeks). Peripheral neuropathy was reported in 6 (9.1%) patients, of whom 4 remained symptomatic for up to 24 months after linezolid discontinuation. Other reported adverse events included nausea (6 [9.1%]), diarrhea (1 [1.5%]), and headache (2 [3.0%]), although none of these patients discontinued treatment. CONCLUSIONS: In this retrospective chart review, treatment with linezolid as monotherapy or in combination with antimicrobials and/or surgery was associated with cure of chronic osteomyelitis in 84.8% of subjects at 12 weeks after the end of treatment and 78.8% at follow-up. Adverse events were reported in 51.5% of subjects, and 34.8% of subjects discontinued the study because of adverse events.
The potential for severe complications justifies close monitoring of these patients.
PMID: 16982292 [PubMed - indexed for MEDLINE]
8) CARLIER JP, MANICH M, LOIEZ C, MIGAUD H, COURCOL RJ : First Isolation of Clostridium amygdalinum from a Patient with Chronic Osteitis. J Clin Microbiol, 2006, 44, 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.
PMID: 17021125 [PubMed - indexed for MEDLINE]
PMCID: PMC1594748
9) LEGOUT L, SENNEVILLE E, STERN R, YAZDANPANAH Y, SAVAGE C, ROUSSEL-DELVALEZ M, ROSELE B, MIGAUD H, MOUTON Y : Treatment of bone and joint infections caused by Gram-negative bacilli with a cefepime-fluoroquinolone combination. Clin Microbiol Infect. 2006, 12(10), 1030-1033.
A 3-year retrospective study evaluated the effectiveness and safety of cefepime plus a fluoroquinolone for treating bone and joint infections caused by Gram-negative bacilli (GNB) in 28 patients. Intra-operative cultures yielded primarily Pseudomonas spp. and Enterobacter cloacae. Full recovery (cure) was observed in 79% of patients. There were no serious adverse effects and no resistant organisms were isolated. The results of the study confirmed the safety and effectiveness of cefepime combined with a fluoroquinolone for the treatment of bone and joint infections caused by Gram-negative bacilli.
PMID: 16961643 [PubMed - indexed for MEDLINE]
10) SENNEVILLE E, LEGOUT L, VALETTE M, YAZDANPANAH Y, BELTRAND E, CAILLAUX M, MIGAUD H, MOUTON Y : Effectiveness and tolerability of prolonged linezolid treatment for chronic osteomyelitis: a retrospective study. Clin Ther, 2006, 28(8), 1155-163.
BACKGROUND: Linezolid is an oxazolidinone agent which is apparently well designed for treating chronic osteomyelitis, but data on effectiveness and tolerability as prolonged therapy is currently lacking. OBJECTIVE: The purpose of this study was to assess the effectiveness and tolerability of linezolid in the treatment of chronic osteomyelitis. METHODS: The charts of hospitalized patients who had been treated with linezolid for >4 weeks because of chronic osteomyelitis and were followed up for > or =12 months after the end of treatment were retrospectively reviewed for clinical outcome and tolerability. Cure was defined as the absence of clinical, biological, or radiological evidence of infection throughout the posttreatment follow-up. Linezolid tolerability was assessed on the basis of hematologic properties during treatment. RESULTS: Of the 66 patients included, all were white (mean [SD] age, 67.7 [18.1] years; 41 men and 25 women; mean [SD] weight, 80.7 [18.6] kg). Thirty-seven (56.1%) patients had infection due to implants including 27 prosthetic joints. Pathogens were predominantly methicillin-resistant staphylococci (49/72 strains, 68.1 %). Every patient was administered N linezolid (600 mg BID) treatment for 6 to 8 days as inpatients, and then, as outpatients, they were switched to PO treatment. Fifty (75.8%) patients received a combination of linezolid and other antimicrobial agents, including rifampin (32 [48.5%]). Surgery was performed in 52 (78.8%) patients. The median hospital stay was 14 days (mean [SD], 19 [11.4] days [range, 7-70 days] ). The median duration of treatment was 13 weeks (mean [SD], 14.3 [8.2] weeks [range, 5-36 weeks]). At the end of treatment, 56 (84.8%) patients were cured, and during the post-treatment follow-up (median duration, 15 months [range, 12-36 months]), 4 relapses occurred, resulting in an overall successful cure for 52 (78.8%) patients. Reversible anemia was reported in 21 patients (31.8%), of whom 16 (24.2%) required blood transfusions. Median time from treatment initiation to anemia onset was 7.3 weeks (range, 4-12 weeks). Peripheral neuropathy was reported in 6 (9.1%) patients, of whom 4 remained symptomatic for up to 24 months after linezolid discontinuation. Other reported adverse events included nausea (6 [9.1%]), diarrhea (1 [1.5%]), and headache (2 [3.0%]), although none of these patients discontinued treatment. CONCLUSIONS: In this retrospective chart review, treatment with linezolid as monotherapy or in combination with antimicrobials and/or surgery was associated with cure of chronic osteomyelitis in 84.8% of subjects at 12 weeks after the end of treatment and 78.8% at follow-up. Adverse events were reported in 51.5% of subjects, and 34.8% of subjects discontinued the study because of adverse events. The potential for severe complications justifies close monitoring of these patients.
PMID: 16982292 [PubMed - indexed for MEDLINE]
11) SADOVSKAYA I, FAURE S, WATIER D, LETERME D, CHOKR A, GIRARD J, MIGAUD H, JABBOURI S. Immunological investigations of a potential use of poly-N-acetyl-{beta}-(1,6)-glucosamine as an antigen for the detection of staphylococcal orthopedic prosthesis-related infections. Clin Vaccine Immunol. 2007, 14(12), 1609-1615.
Staphylococcus aureus and coagulase-negative staphylococci are microorganisms most frequently isolated from orthopedic-implant-associated infections. Their capacity to maintain these infections is thought to be related to their ability to form adherent biofilms.
Poly-N-acetyl-beta-(1,6)-glucosamine (PNAG) is an important constituent of the extracellular biofilm matrix of staphylococci.
In the present study, we explored the possibility of using PNAG as an antigen for detecting antibodies in the blood sera of patients with staphylococcal orthopedic-prosthesis-associated infections. First, we tested the presence of anti-PNAG antibodies in an animal model, in the blood sera of guinea pigs that developed an implant-associated infection caused by biofilm-forming, PNAG-producing strains of Staphylococcus epidermidis. Animals infected with S. epidermidis RP62A showed levels of anti-PNAG immunoglobulin G (IgG) significantly higher than those of the control group. The comparative study of healthy individuals and patients with staphylococcal prosthesis-related infections showed that (i) relatively high levels of anti-PNAG IgG were present in the blood sera of the healthy control group, (ii) the corresponding levels in the infected patients were slightly but not significantly higher, and (iii) only 1 of 10 patients had a level of anti-PNAG IgM significantly higher than that of the control group. In conclusion, the encouraging results obtained in the animal study could not be readily applied for the diagnosis of staphylococcal orthopedic-prosthesis-related infections in humans, and PNAG does not seem to be an appropriate antigen for this purpose. Further studies are necessary to determine whether the developed enzyme-linked immunosorbent assay method could serve as a complementary test in the individual follow-up treatment of such infections caused by PNAG-producing staphylococci.
PMID: 17942607 [PubMed - indexed for MEDLINE]
12) SENNEVILLE E, POISSY J, LEGOUT L, DEHECQ C, LOÏEZ C, VALETTE M, BELTRAND E, CAILLAUX M, MOUTON Y, MIGAUD H, YAZDANPANAH Y. Safety of prolonged high-dose levofloxacin therapy for bone infections. J Chemother. 2007 Dec;19(6):688-93.
The records of 84 patients with bone infections treated with high-dose levofloxacin (i.e. 0.75-1g daily) for more than 4 weeks were reviewed. Patients were given either 500 mg b.i.d. throughout the treatment period [Group 1 (n=41)], 500 mg b.i.d. for 3 weeks and then 750 mg q.d. [Group 2 (n=21)] or 750 mg q.d. for the whole treatment period [Group 3 (n=22)]. All patients had combined therapy, including levofloxacin-rifampin in 62 cases (73.8%), for an average duration of 13.7 weeks. Muscular pain and/or tendonitis were reported in 19 patients (22.6%) which affected more patients in Groups 1 and 2 than in Group 3 (14/41 and 5/21 vs. 0/22; p=0.01 and 0.001, respectively). A dosage of 750 mg q.d. may be warranted for prolonged high-dose levofloxacin treatment in patients with bone infections rather than 500 mg b.i.d. for the entire duration of treatment, or for the first 3 weeks.
PMID: 18230552 [PubMed - in process]
13) SENNEVILLE E, LOMBART A, BELTRAND E, VALETTE M, LEGOUT L, CAZAUBIEL M, YAZDANPANAH Y, FONTAINE P. Outcome of diabetic foot osteomyelitis treated nonsurgically: a retrospective cohort study. Diabetes Care. 2008 Apr;31(4):637-42.s
OBJECTIVE: The purpose of this article was to identify criteria predictive of remission in nonsurgical treatment of diabetic foot osteomyelitis. RESEARCH DESIGN AND METHODS: Diabetic patients who were initially treated without orthopedic surgery for osteomyelitis of the toe or metatarsal head of a nonischemic foot between June 2002 and June 2003 in nine French diabetic foot centers were identified, and their medical records were reviewed. Remission was defined as the absence of any sign of infection at the initial or contiguous site assessed at least 1 year after the end of treatment. A total of 24 demographic, clinical, and therapeutic variables including bone versus swab culture-based antibiotic therapy were analyzed. RESULTS: Fifty consecutive patients aged 62.2 +/- 11.1 years (mean +/- SD) with diabetes duration of 16 +/- 10.9 years were included. The mean duration of antibiotic treatment was 11.5 +/- 4.21 weeks. Bone biopsy was routinely available in four of the nine centers. Overall patient management was similar in the different centers except for the use of rifampin, which was recorded more frequently in patients from centers in which a bone biopsy was available. At the end of a 12.8-month posttreatment mean follow-up, 32 patients (64%) were in remission. Bone culture-based antibiotic therapy was the only variable associated with remission, as determined by both univariate (18 of 32 [56.3%] vs. 4 of 18 [22.2%], P = 0.02) and multivariate analyses (odds ratio 4.78 [95% CI 1.0-22.7], P = 0.04). CONCLUSIONS: Bone culture-based antibiotic therapy is a factor predictive of success in diabetic patients treated nonsurgically for osteomyelitis of the foot.
PMID: 18184898 [PubMed - in process]
14) HARTEMANN-HEURTIER A, SENNEVILLE E Diabetic foot osteomyelitis. Diabetes Metab. 2008 Apr;34(2):87-95.
Bone infection in the diabetic foot is always a complication of a preexisting infected foot wound. Prevalence can be as high as 66%. Diagnosis can be suspected in two mains conditions: no healing (or no depth decrease) in spite of appropriate care and off-loading, and/or a visible or palpated bone with a metal probe. The first recommended diagnostic step is to perform (and if necessary to repeat) plain radiographs. After a four-week treatment period, if plain radiographs are still normal, suspicion for bone infection will persist in case of bad evolution despite optimized management of off-loading and arterial disease. It is only in such cases that other diagnosis methods than plain radiographs must be used. Staphylococcus aureus is the most common pathogen cultured from bone samples, followed by Staphylococcus epidermidis. Among enterobacteriaceae, Escherichia coli, Klebsiella pneumonia and Proteus sp. are the most common, followed by Pseudomonas aeruginosa. Surprisingly, bacteria usually considered contaminant (as coagulase negative staphylococci (CNS) and Corynebacterium sp.) have been documented to be pathogens in the osteomyelitis of diabetic foot. Traditional approach to treatment of chronic osteomyelitis was by surgical resection of infected and necrotic bone. But new classes of antibiotics have both the required spectrum of activity and the capacity to penetrate and concentrate in the infected bone. Recently, several observations of osteomyelitis remission following non-surgical management with a prolonged course of antibiotics have been published. Lastly, combined approach with local bone excision and antibiotics has been proposed. Prospective trials should be undertaken to determine the relative roles of surgery and antibiotics in managing diabetic foot osteomyelitis.
PMID: 18242114 [PubMed - in process]
15) NGUYEN S, PASQUET A, LEGOUT L, BELTRAND E, DUBREUIL L, MIGAUD H, YAZDANPANAH Y, SENNEVILLE E Efficacy and tolerance of rifampicin-linezolid compared with rifampicin-cotrimoxazole combinations in prolonged oral therapy for bone and joint infections. Clin Microbiol Infect. 2009 May 4.
Both linezolid and cotrimoxazole are antibiotics that are well suited for oral therapy of bone and joint infections (BJI) caused by otherwise resistant Gram-positive cocci (GPC) (resistance to fluoroquinolones, maccolides, betalactamines). However, in this context, no data are currently available regarding the safety and tolerance of these antibiotics in combination with rifampicin. The objective of this study was to compare the efficacy and safety of a combination of rifampicin and linezolid (RLC) with those of a combination of rifampicin and cotrimoxazole (RCC) in the treatment of BJI. Between February 2002 and December 2006, 56 adult patients (RLC, n = 28; RCC, n = 28), including 36 with infected orthopaedic devices (RLC, n = 18; RCC, n = 18) and 20 with chronic osteomyelitis (RLC, n = 10; RCC, n = 10), were found to be eligible for inclusion in this study. Patients who discontinued antibiotic therapy within 4 weeks of commencing treatment were considered to represent cases of treatment failure and were excluded. Rates of occurrence of adverse effects were similar in the two groups, at 42.9% in the RLC group and 46.4% in the RCC group (p = 1.00), and led to treatment discontinuation in four (14.3%) RLC and six (21.4%) RCC patients. Cure rates were found to be similar in the two groups (RLC, 89.3%, RCC, 78.6%; p = 0.47). Prolonged oral RLC and RCC therapy were found to be equally effective in treating patients with BJI caused by resistant GPC, including patients with infected orthopaedic devices. However, the lower cost of cotrimoxazole compared with linezolid renders RCC an attractive treatment alternative to RLC. Further larger clinical studies are warranted to confirm these preliminary results.
PMID: 19438638 [PubMed - as supplied by publisher]
16) LANGLAIS F, JUDET H, VIELPEAU C, BERNARD L, CHAUVEAUX D, BEAUFILS P, BERNARD L, DUJARDIN F, HAMADOUCHE M, MAMOUDY P, MIGAUD H, MINET J, PEGOIX M, SENNEVILLE E, TABUTIN J, BONNOMET F, CAILLON J, POTEL G, ROSENCHER N, SAMAMA CM. Use of acrylic cement with antibiotic in primary arthroplasty. Rev Chir Orthop Reparatrice Appar Mot. 2008 Oct;94 Suppl(6):S215-8.
Recommandations pour la pratique clinique : A l’issue des réunions du jury, il a été établi les recommandations suivantes, qui ont été exposées lors la séance publique du 5 novembre pendant le congrès de l’Académie d’orthopédie—traumatologie dans le cadre de la Sofcot.
Grade A Compte tenu de l’efficacité avérée sur le plan infectieux, et de l’absence de risque supplémentaire sur le plan mécanique, il est recommandé d’utiliser un ciment contenant un aminoside (gentamicine, tobramycine), dans le cadre d’une prophylaxie anti-infectieuse, lors d’une arthroplastie primaire cimentée
Grade B Lorsqu’un ciment contenant un antibiotique est utilisé, à titre prophylactique, il est recommandé d’utiliser un mélange industriel plutôt qu’un mélange extemporané.
Grade D Préalablement à l’utilisation d’un ciment contenant un antibiotique il est recommandé de rechercher, par l’interrogatoire, une allergie à l’antibiotique utilisé.
Grade D Lorsqu’une arthroplastie primaire, scellée avec un ciment-antibiotique, doit être reprise pour infection, il est recommandé de tenir compte d’un risque accru de germes résistants à l’antibiotique utilisé initialement
Grade D Compte tenu du risque théorique de toxicité rénale, il est recommandé de ne pas utiliser un ciment-aminoside chez l’insuffisant rénal sévère ou en association avec d’autres médicaments néphrotoxiques par voie générale.
PMID: 18928818 [PubMed - indexed for MEDLINE]
17) CARLIER JP, MANICH M, LOÏEZ C, MIGAUD H, COURCOL RJ. First isolation of Clostridium amygdalinum from a patient with chronic osteitis. J Clin Microbiol. 2006 Oct;44(10):3842-4.
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.
PMID: 17021125 [PubMed - indexed for MEDLINE]
18) GASIUNAS V, PLENIER I, HERENT S, MAY O, SENNEVILLE E, MIGAUD H. Transabdominal removal of femoral and acetabular components of a severely protruded and infected hip arthroplasty with urinary tract complications. Rev Chir Orthop Reparatrice Appar Mot. 2005 Jun;91(4):346-50.
We present the first report of transabdominal removal of femoral and acetabular components of a severely loosened hip prosthesis protruding into the pelvis. In a 73-year-old woman post-operative development of urinary tract complications emphasize importance of careful assessment of the prosthetic relations with the vascular and nervous structures as well as pelvic organs before removal of the hip prosthesis. Angio-computed tomography is the most contributive exploration to assess vascular relations. In patients with particular clinical presentations or with threatened structures in the vicinity of the prosthesis, this examination must be completed by complementary opacifications (urinary and gastrointestinal tracts, joints). Ureteral catheterization may be needed if the structures are close or if there is a suspected modification of the urinary tract (retraction, mass effect). In present case, we did not opacify the urinary tract before laparatomy despite the presence of urinary signs preoperatively. A suspected ureterovaginal fistula was discovered. But they where also a ureteral lesions which can result from difficult dissection in contact with infected tissues. In this patient, urinary complications led to nephrectomy after temporary pyelostomy for urine bypass. At last follow-up, the urinary tract infection was controlled but reimplantation was not attempted because of insulin dependent diabetes mellitus and poor general condition. The spontaneous course of this infection with prosthesis loosening recalls the importance of regular surveillance of total hip replacements.
PMID: 16158550 [PubMed - indexed for MEDLINE]
19) SENNEVILLE E, MIGAUD H, PINOIT Y, SAVAGE C, LAFFARGUE P, DESPLACES N. Modalités et facteurs de guérison de l’antibiothérapie systémique. Rev Chir Orthop Reparatrice Appar Mot. 2002;88 Suppl5, 184-186.
Les résultats de cette étude rétrospective comprenant plus de 500 patients recrutés sur une période de temps restreinte et bénéficiant d’un recul d’au moins deux ans pour l’évaluation clinique de la guérison ne peuvent cependant pas conduire à des conclusions définitives mais permettent de définir quelques axes de recherche dans le domaine de l’antibiothérapie tels que l’intérêt de la rifampicine dans les schémas thérapeutiques de patients bénéficiant d’un changement de matériel (et le retentissement écologique de ce type d’antibiothérapie à « haut risque »), le bénéfice des associations glycopeptides-rifampicine par rapport aux associations « traditionnelles » rifampicinefluoroquinolones et les durées minimales efficaces des traitements antibiotiques. Cette étude démontre, s’il en était besoin, le potentiel des centres français d’orthopédie pour colliger les données relatives aux patients porteurs d’une infection sur matériel.
20) LOÏEZ C, TAVANI F, WALLET F, FLAHAUT B, SENNEVILLE E, GIRARD J, COURCOL RJ. An unusual case of prosthetic joint infection due to Arcanobacterium bernardiae. J Med Microbiol 2009; 58:842-3.
PMID: 19429766 [PubMed - indexed for MEDLINE]
21) SENNEVILLE E, MORANT H, DESCAMPS D, DEKEYSER S, BELTRAND E, SINGER B, CAILLAUX M, BOULOGNE A, LEGOUT L, LEMAIRE X, LEMAIRE C, YAZDANPANAH Y. Needle puncture and transcutaneous bone biopsy cultures are inconsistent in patients with diabetes and suspected osteomyelitis of the foot. Clin Infect Dis. 2009; 48: 888-93.
BACKGROUND: Needle puncture has been suggested as a method for identifying bacteria in the bones in patients with diabetes with osteomyelitis of the foot. However, no studies have compared needle puncture with concomitant transcutaneous bone biopsy, which is the current standard recommended in international guidelines. METHODS: We conducted a prospective study in 2 French diabetes foot clinics. Transcutaneous bone biopsy specimens, needle puncture specimens, and swab samples were collected on the same day for each patient. RESULTS: Overall, 31 patients were included in the study from July 2006 through February 2008. Twenty-one bone biopsy specimens (67.7%), 18 needle puncture specimens (58%), and 30 swab samples (96.7%) had positive culture results. Staphylococcus aureus was the most common type of bacteria that grew from bone samples, followed by Proteus mirabilis and Morganella morganii. The mean number of bacteria types per positive sample were 1.35, 1.32, and 2.51 for bone biopsy specimens, needle puncture specimens, and swab samples, respectively. Among the 20 patients with positive bone biopsy specimens (69%), 13 had positive needle puncture samples. Overall, the correlation between microbiological results was 23.9%, with S. aureus showing the strongest correlation (46.7%). Results of cultures of bone biopsy and needle puncture specimens were identical for 10 (32.3%) of 31 patients. Bone bacteria were isolated from the needle punctures in 7 (33.3%) of the 21 patients who had positive bone biopsy specimen culture results. If the results of cultures of needle puncture specimens alone had been considered, 5 patients (16.1%) would have received unnecessary treatment, and 8 patients (38.1%) who had positive bone culture results would not have been treated at all. CONCLUSIONS:Our results suggest that needle punctures, compared with transcutaneous bone biopsies, do not identify bone bacteria reliably in patients with diabetes who have low-grade infection of the foot and suspected osteomyelitis.
PMID: 19228109 [PubMed - indexed for MEDLINE]
22) BERENDT AR, PETERS EJ, BAKKER K, EMBIL JM, ENEROTH M, HINCHLIFFE RJ, JEFFCOATE WJ, LIPSKY BA, SENNEVILLE E, TEH J, VALK GD. Diabetic foot osteomyelitis: a progress report on diagnosis and a systematic review of treatment. Diabetes Metab Res Rev. 2008; 24 Suppl 1:S145-61.
The International Working Group on the Diabetic Foot appointed an expert panel to provide evidence-based guidance on the management of osteomyelitis in the diabetic foot. Initially, the panel formulated a consensus scheme for the diagnosis of diabetic foot osteomyelitis (DFO) for research purposes, and undertook a systematic review of the evidence relating to treatment. The consensus diagnostic scheme was based on expert opinion; the systematic review was based on a search for reports of the effectiveness of treatment for DFO published prior to December 2006.The panel reached consensus on a proposed scheme that assesses the probability of DFO, based on clinical findings and the results of imaging and laboratory investigations.The literature review identified 1168 papers, 19 of which fulfilled criteria for detailed data extraction. No significant differences in outcome were associated with any particular treatment strategy. There was no evidence that surgical debridement of the infected bone is routinely necessary. Culture and sensitivity of isolates from bone biopsy may assist in selecting properly targeted antibiotic regimens, but empirical regimens should include agents active against staphylococci, administered either intravenously or orally (with a highly bioavailable agent). There are no data to support the superiority of any particular route of delivery of systemic antibiotics or to inform the optimal duration of antibiotic therapy. No available evidence supports the use of any adjunctive therapies, such as hyperbaric oxygen, granulocyte-colony stimulating factor or larvae.We have proposed a scheme for diagnosing DFO for research purposes. Data to inform treatment choices in DFO are limited, and further research is urgently needed.
PMID: 18442163 [PubMed - indexed for MEDLINE]
23) BERENDT AR, PETERS EJ, BAKKER K, EMBIL JM, ENEROTH M, HINCHLIFFE RJ, JEFFCOATE WJ, LIPSKY BA, SENNEVILLE E, TEH J, VALK GD. Specific guidelines for treatment of diabetic foot osteomyelitis. Diabetes Metab Res Rev. 2008; 24 Suppl 1:S190-1.
PMID: 18442187 [PubMed - indexed for MEDLINE
24) MAYNOU C, MÉNAGER S, SENNEVILLE E, BOCQUET D, MESTDAGH H. Clinical results of resection arthroplasty for infected shoulder arthroplasty. Rev Chir Orthop Reparatrice Appar Mot. 2006; 92:567-74.
PURPOSE OF THE STUDY: Infection is a rare complication of shoulder arthroplasty. Various therapeutic solutions have been proposed: antibiotics alone, one-stage or two-stage reimplantation, surgical or arthroscopic cleaning without prosthesis removal, scapulohumeral arthrodesis or simple arthroscopic resection. We evaluated the mid-term clinical outcome after resection arthroplasty for the treatment of infected shoulder arthroplasty. MATERIAL AND METHODS: The series included ten infected arthroplasties in ten patients. Mean duration of implantation was two years seven months (range nine months to five years). Bacteriological diagnosis was established from intraoperative articular samples or systematic samples taken during surgical revision procedures: meti-S Staphylococcus aureus strains (n=4), coagulase-negative Staphylococcus (n=5 including three S. epidermidis) Streptococcus mitis (n=1) and Citrobacter koseri (n=1). The mean Constant score before revision was 58 (range 23-77). Subjective patient satisfaction before surgical revision was rated good in six cases, fair in one and poor in three. Surgery associated removal of the implant, complete resection of the cement, resection of the fistular tracts, wide debridement of infected tissues and total synovectomy. RESULTS: Patients were seen at an average follow-up of three years eight months. The objective functional outcome measured with the Constant score was only fair, 28 points (range 20.6-36), and corresponded to a loss of 29 points compared with the preoperative score. This was explained mainly by lower scores for joint motion, function and muscle force but with persistently satisfactory scores for pain. All patients remained pain-free (daytime and nighttime). Patient satisfaction was rated good for two, fair for five and mediocre for three. Clinical and biological proof of eradicated infection was obtained in all patients. DISCUSSION: Infection remains a serious devastating problem for shoulder arthroplasty with an important functional impact. Resection only has a modest clinical effect. Precise identification of the causal germ with institution of adapted antibiotic therapy is required for eradication of the infection. Early diagnosis is probably the most important parameter affecting clinical outcome and surgical options. Functional results after resection arthroplasty are modest. This procedure should be reserved for patients with reduced functional demands. Improved management of the infectious load and reduction of diagnostic delay should help improve functional outcome and favor use of stow-stage procedures for reinsertion.
PMID: 17088753 [PubMed - indexed for MEDLINE]
PUBLICATIONS NATIONALES
25) SENNEVILLE E, LEGOUT L, CORROYER B, YAZDANPANAH Y, MOUTON Y. Adequate use of teicoplanin in bone and joint infections. Med Mal Infect. 2004 Jun; 34 (Suppl 1): S99-S102
PMID: 15676260 [PubMed - as supplied by publisher]
26) SENNEVILLE E. Diabetic foot osteomyelitis Rev Prat. 2007 May 15;57(9):991-4.
Bone and joint infections associated with chronic wound of the diabetic foot are frequent and severe complications that should be considered in most cases. Early diagnosis and aggressive treatment are likely to limit bad outcome. Clinical studies with acceptable methodology addressing the relative role of medical and surgical approaches are needed. Bone biopsy available in routine in a diabetic foot clinic represents a marker of good quality of management of such patients. Given the global burden and potential severity of osteomyelitis of the diabetic foot, every measure that can prevent the occurrence and persistence of a foot wound in a diabetic patient remain major objectives.
PMID: 17695679 [PubMed - indexed for MEDLINE]
27) SENNEVILLE E. Infection and diabetic foot. Rev Med Interne. 2008; 29 Suppl 2: S243-8.
The large number of factors that influence the outcome of patients with diabetic foot infections calls for a multidisciplinary management of such patients. Infection is always the consequence of a preexisting foot wound whose chronicity is facilitated by the diabetic peripheral neuropathy, whereas peripheral vascular disease is a factor of poor outcome, especially regarding the risk for leg amputation. Primary and secondary prevention of IPD depends both on the efficacy of wound off-loading. Antibiotic treatment should only be considered for clinically infected foot wounds for which diagnostic criteria have recently been proposed by international consensus. The choice of the antibiotic regimen should take into account the risk for selecting bacterial resistance, and as a consequence, agents with a narrow spectrum of activity should be preferred. Respect of the measures for preventing the spread of bacterial resistance in diabetic foot centers is particularly important.
PMID: 18822250 [PubMed - indexed for MEDLINE]
28) PINOIT Y, SENNEVILLE E, MIGAUD H. Acute soft tissue infections. Rev Prat. 2006 Jun 30;56(12):1363-8. Review.
PMID: 16948228 [PubMed - indexed for MEDLINE]
29) GRADOS F, LESCURE FX, SENNEVILLE E, FLIPO RM, SCHMIT JL, FARDELLONE P. Suggestions for managing pyogenic (non-tuberculous) discitis in adults. Joint Bone Spine. 2007; 4:133-9.
OBJECTIVES: To develop recommendations about identifying the causative organism, obtaining imaging studies, and selecting pharmacological and non-pharmacological treatments in adults with pyogenic discitis and vertebral osteomyelitis (PDVO). METHODS: A rheumatologist and an infectiologist drafted recommendations based on their personal experience and a review of studies in English or French retrieved on Medline using the following search terms: "infectious spondylodiscitis", "infectious spondylitis", "spondylodiscitis", "discitis", "vertebral osteomyelitis", "spine infection", and "bone and joint infections". The recommendations were submitted to four experts for validation. RESULTS: 85 articles were selected for detailed review. No prospective randomized controlled trials were identified. Antimicrobial therapy should be initiated only after recovery of the causative organism in blood cultures or percutaneous disk biopsy specimens, except in patients with neutropenia or severe sepsis. The initial treatment rests on a combination of two bactericidal and synergistic antimicrobials in high dosages. The total duration of antimicrobial therapy should be 12 weeks at least. Radiographs of the spine and chest and magnetic resonance imaging (MRI) of the spine should be performed routinely during the initial evaluation. In PDVO due to hematogenous dissemination of a streptococcus or staphylococcus, routine echocardiography may be in order. Radiographs centered on the affected disk should be obtained 1 and 3 months into antimicrobial therapy and 3 months after treatment discontinuation. Follow-up MRI is usually unnecessary when the clinical and laboratory abnormalities respond to treatment. If not, or if the initial investigations show a collected abscess, a repeat MRI after 1 month of antimicrobial treatment may be useful. Clinical and laboratory follow-up is mandatory throughout antimicrobial therapy and during the first 6 months after treatment discontinuation. CONCLUSIONS: Recommendations based on descriptive studies and expert opinion were developed. They can be expected to improve the quality and uniformity of PDVO management. Further studies are needed to improve the level of evidence that is available for developing recommendations. In particular, prospective randomized multicenter studies should be performed to compare the intravenous to the oral route for initial antimicrobials administration and to compare different treatment durations.
PMID: 17337352 [PubMed - indexed for MEDLINE].
30) LOÏEZ C, WALLET F, PISCHEDDA P, RENAUX E, SENNEVILLE E, MEHDI N, COURCOL RJ. First case of osteomyelitis caused by "Staphylococcus pettenkoferi". J Clin Microbiol. 2007; 45:1069-71.
"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.
PMID: 17202276 [PubMed - indexed for MEDLINE]
31) MULLEMAN D, PHILIPPE P, SENNEVILLE E, COSTES C, FAGES L, DEPREZ X, FLIPO RM, DUQUESNOY B. Streptococcal and enterococcal spondylodiscitis (vertebral osteomyelitis). High incidence of infective endocarditis in 50 cases. J Rheumatol. 2006; 33: 91-7
OBJECTIVE: To characterize the clinical, biological, and imaging features and outcomes of patients with streptococcal and enterococcal spondylodiscitis (SESD). METHODS: This retrospective study of patients with SESD was carried out in 2 departments of rheumatology from 1990 through 2002. Comparison was made with cases of staphylococcal spondylodiscitis (SSD) seen during the same period, excluding postoperative cases. RESULTS: Fifty cases of SESD were reviewed and compared with 86 cases of SSD. The main finding was a higher frequency of concomitant infective endocarditis in patients with SESD (11/42 vs 1/37; p = 0.009). Evidence of inflammation, imaging features, and neurological impairment at admission appeared to be less severe in SESD, but the difference did not reach statistical significance. Duration of treatment was shorter in SESD than in SSD (105 +/- 26 days vs 130 +/- 49 days; p = 0.003). CONCLUSION: Our study confirms the high incidence of infective endocarditis (26%) during SESD. Clinicians must look for predisposing factors and clinical abnormalities in patients with spondylodiscitis whenever a streptococcal or enterococcal agent is identified. Echocardiography should be performed as routine in such situations.
PMID: 16395756 [PubMed - indexed for MEDLINE]
32) YAZDANPANAH Y, LEMAIRE X, SENNEVILLE E, DELCEY V, VIGET N, MOUTON Y, AJANA F, DUBREUIL L. Melioidotic osteomyelitis of the femur occurring in a traveler. J Travel Med. 2002 Jan-Feb;9(1):53-4.
PMID: 11953265 [PubMed - indexed for MEDLINE]
33) SENNEVILLE E, YAZDANPANAH Y, CORDONNIER M, CAZAUBIEL M, LEPEUT M, BACLET V, BELTRAND E, KHAZARJIAN A, CAILLAUX M, DUBREUIL L, MOUTON Y. Are the principles of treatment of chronic osteitis applicable to the diabetic foot? Presse Med. 2002; 31:393-9.
OBJECTIVE: The interest of the management of bone infections in the diabetic foot, inspired by the recommendations for the treatment of chronic osteitis, was assessed in this study. METHODS: Twenty bone infections in 17 diabetic patients with moderate to mild infections of the feet were confirmed by the results of X-ray and/or scintigraphic studies and bone surgery biopsy cultures revealing one or more bacteria sensitive to standard osteitis treatment (rifampicine + fluoroquinolone). The patients had received this treatment per os for a median duration of 6 months (3 to 10 months). Clinical follow-up was carried out during a consultation at 1, 3 and 6 months during treatment and then by telephone every six months after the end of treatment. Clinical success was defined as the disappearance of any local sign of infection and by the absence of relapse during the post-treatment follow-up period. The evolution of the bone infection was also assessed by the results of a control conducted 3 to 6 months after initiation of the antibiotic treatment. RESULTS: At the end of the treatment, all signs of infection had disappeared in 15/17 patients (88.2%) and no relapse had occurred in 14 (82.3%) patients at the end of a median post-treatment period of 22 months (12 to 41 months). Resection of necrotic bone was performed at the same time as the bone biopsy in 2 patients. The median duration of hospitalisation was of 14 days (3 to 53 days). During the study, a multi-resistant germ was isolated in 4 patients (1 Pseudomonas aeruginosa, 3 Staphylococcus aureus). During the post-treatment follow-up, 3 patients dies from causes unrelated to the infection treated. No serious adverse event was reported during the study. DISCUSSION: The results of this pilot study support the rationale of applying the treatment regimens of chronic osteitis to diabetic lesions of the feet, but are only applicable to comparable patients presenting with non-severe lesions of the feet. Moreover, the use of antibiotics with potent selection of resistance such as rifampicine and fluoroquinolone, requires that bone biopsies be taken, which is not easy in all the diabetic foot care centres. We are presently conducting a study to identify the sub-populations of diabetic patients who could benefit from such treatment.
PMID: 11933734 [PubMed - indexed for MEDLINE]
