Summary. Despite the improvement in the quality of implants, the number of complications in traumatology and orthopedics, which lead to infection, remains high. It is proved that untimely prescription of adequate antibiotic therapy for implant-associated infections can cause progression of the septic process until the development of shock and multiorgan failure and on practics leads to the development of resistance microorganisms to antibacterial drugs. An important point is to study the pathological microbial communities (bacterial film) in traumatology and orthopedics. All "classic" tests and markers of the infectious processhave low specificity and are not reliable enough for accurate diagnosis. These features are forced to development of additional microbiological diagnostics: the study of the destruction of the biofilm, which is removed from the implant surface with the help of ultrasound. The purpose of our study was to determine the effectiveness of the microbiological tests with sonication in patients with infectious process after osteosynthesis of long bones. Materials and Methods. Microbiological studies of the pathologically altered tissue biopsies directly at the implant and implant sonicates from the implant for osteosynthesis from 31 patients with chronic osteomyelitis or surgical site infection were performed. Results. As a result, the significant sonication efficiency was discovered: a 25.8% increase in positive results, 6.5% of E. aerogenes and E. faecalis cultures in association with S. aureus were isolated. Conclusions. Further improvement of the method and its application in specialized departments can give a positive diagnostic effect, which will subsequently improve the results of patient treatment.
Fang C, Tak-Man Wong, Tak-Wing Lau. Infection after fracture osteosynthesis – Part I: pathogenesis, diagnosis and classification. Journal of Orthopaedic Surgery. 2017;25(1):1-13. DOI: 10.1177%2F2309499017692712.
Liang Y, Fang Y, Tu CQ, Yao XY, Yang TF. Analyzing risk factors for surgical site infection following Pilon fracture surgery. Zhongguo Gu Shang. 2014;27(8):650-3. PMID: 25464589.
Metsemakers WJ, Handojo K, Reynders P, Sermon A, Vanderschotet P, Nijsal S. Individual risk factors fordeep infection and compromised fracture healing after intramedullary nailing of tibial shaft fractures: asingle centre experience of 480 patients. Injury 2015;46(4):740-5. DOI: 1016/j.injury.2014.12.018.
Costerto JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science. 1999;284:1318-22. DOI: 10.1126/science.284.5418.1318.
Zimmerli W, Moser C. Pathogenesis and treatment concepts of orthopaedic biofilm infections. FEMS Immunol Med Microbiol. 2012;65(2):158-68. DOI: 10.1111/j.1574-695X.2012.00938.x.
Tande AJ, Patel R. Prosthetic joint infection. Clin. Microbiol. Rev. 2014;27(2):302-45. DOI: 10.1128/CMR.00111-13.
Esteban J, Sandoval E, Cordero-Ampuero J, Molina-Manso D, Ortiz-Pérez A, Fernández-Roblas R, Gómez-Barrena E. Sonication of intramedullary nails: clinically-related infection and contamination. Open Orthop J. 2012;6:255-60. DOI: 10.2174/1874325001206010255.
Maniar HH, Wingert N, McPhillips K, Foltzer M, Graham J, Bowen TR, Horwitz DS. Role of sonication for detection of infection in explanted orthopaedic trauma implants. Journal of Orthopaedic Trauma. 2016;30(5):e175-e80. DOI: 10.1097/BOT.0000000000000512.
This work is licensed under a Creative Commons Attribution 4.0 International License.