The University of Southampton
University of Southampton Institutional Repository

Adaptive antimicrobial resistance - description of microbial variants & their relevance in PJI: a review

Adaptive antimicrobial resistance - description of microbial variants & their relevance in PJI: a review
Adaptive antimicrobial resistance - description of microbial variants & their relevance in PJI: a review
Periprosthetic joint infection (PJI) is a difficult complication requiring an aggressive eradication protocol. Treatment cure rates remain essentially stalled in the last two decades utilizing methods of antimicrobial cement joint spacers and parenteral antimicrobial agents. Functional spacers with higher dose antimicrobial loaded cement and antimicrobial loaded CaSO4 beads have emphasized local antimicrobial delivery with the premise that high dose local antimicrobial delivery will positively impact eradication. However, with increasing antimicrobial pressures, microbiota have responded with adaptive mechanisms beyond traditional antimicrobial resistance genes. For this discussion we describe adaptive resistance mechanisms that are relevant to the treatment of PJI. Some mechanisms are well known, but others are new. The objective of this review is to inform physicians and specialist alike regarding the known adaptive resistance mechanisms of microbes relevant to PJI. We also discuss the implications of these adaptive mechanisms in the future treatment of PJI.
2049-4394
575–580
Hamad, Christopher
a45900a8-2f50-47ee-868b-6bd067fcaa78
Chowdry, Madhav
e92d3348-7304-491b-8e94-0e00b2f376a7
Sindeldecker, Devin
53899a0e-6c67-40e4-813d-ce3e907f3ee8
Bernthal, Nicholas M
6bab0806-724b-47d4-b8e0-f777a6c5d4c4
Stoodley, Paul
08614665-92a9-4466-806e-20c6daeb483f
McPherson, Edward J.
d00c0949-e3f3-4ecf-ae19-18449073d4f5
Hamad, Christopher
a45900a8-2f50-47ee-868b-6bd067fcaa78
Chowdry, Madhav
e92d3348-7304-491b-8e94-0e00b2f376a7
Sindeldecker, Devin
53899a0e-6c67-40e4-813d-ce3e907f3ee8
Bernthal, Nicholas M
6bab0806-724b-47d4-b8e0-f777a6c5d4c4
Stoodley, Paul
08614665-92a9-4466-806e-20c6daeb483f
McPherson, Edward J.
d00c0949-e3f3-4ecf-ae19-18449073d4f5

Hamad, Christopher, Chowdry, Madhav, Sindeldecker, Devin, Bernthal, Nicholas M, Stoodley, Paul and McPherson, Edward J. (2022) Adaptive antimicrobial resistance - description of microbial variants & their relevance in PJI: a review. The Bone & Joint Journal, 104-B (5), 575–580. (doi:10.1302/0301-620X.104B5.BJJ-2021-1759.R1).

Record type: Article

Abstract

Periprosthetic joint infection (PJI) is a difficult complication requiring an aggressive eradication protocol. Treatment cure rates remain essentially stalled in the last two decades utilizing methods of antimicrobial cement joint spacers and parenteral antimicrobial agents. Functional spacers with higher dose antimicrobial loaded cement and antimicrobial loaded CaSO4 beads have emphasized local antimicrobial delivery with the premise that high dose local antimicrobial delivery will positively impact eradication. However, with increasing antimicrobial pressures, microbiota have responded with adaptive mechanisms beyond traditional antimicrobial resistance genes. For this discussion we describe adaptive resistance mechanisms that are relevant to the treatment of PJI. Some mechanisms are well known, but others are new. The objective of this review is to inform physicians and specialist alike regarding the known adaptive resistance mechanisms of microbes relevant to PJI. We also discuss the implications of these adaptive mechanisms in the future treatment of PJI.

Text
Main Document - Revised (1) - Accepted Manuscript
Download (101kB)

More information

Accepted/In Press date: 11 February 2022
e-pub ahead of print date: 2 May 2022

Identifiers

Local EPrints ID: 455008
URI: http://eprints.soton.ac.uk/id/eprint/455008
ISSN: 2049-4394
PURE UUID: 9c886888-3147-4716-9f74-82b86051b59d
ORCID for Paul Stoodley: ORCID iD orcid.org/0000-0001-6069-273X

Catalogue record

Date deposited: 03 Mar 2022 17:43
Last modified: 17 Mar 2024 07:08

Export record

Altmetrics

Contributors

Author: Christopher Hamad
Author: Madhav Chowdry
Author: Devin Sindeldecker
Author: Nicholas M Bernthal
Author: Paul Stoodley ORCID iD
Author: Edward J. McPherson

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×