Orthopedic infections

Include osteomyelitis and hardware-associated infections which are most commonly caused by gram positive cocci such as Staphylococci and enterococci.

Common in drug users, occurring as hematogenous seeding.

Intravenous vancomycin is the first-line treatment for the usual orthopedic infections.

Vertebral osteomyelitis in injection drug users often caused by bacteria, mainly Staphylococcus aureus, Gram negative aerobic rods, and group A and group G streptococci and may be polymicrobial.

Linezolid an effective alternative agent in patients with linezolid-susceptible gram positive bacterial infections.

Surgical-site infection (SSI) after total joint arthroplasty (TJA) continues to pose a challenge and place a substantial burden on patients, surgeons, and the healthcare system.

Estimated 1.0% to 2.5% annual incidence of surgical-site infection after total joint arthroplasty.

Advances in surgical technique, sterile protocol, and operative procedures have minimized SSIs

Preoperative skin preparation have shown varying outcomes after TJA.

Preoperative patient optimization of nutritional status, immune function, and metabolic control are essential to prevent infection.

Intraoperative infection prevention measures include: skin preparation, gloving, surgical drapes, OR staff traffic and ventilation flow, and antibiotic-loaded cement.

Revision procedures for infection after total hip arthroplasty are associated with more hospitalizations, more operations, longer hospital stay, and higher outpatient costs in comparison with primary total hip replacement or revision surgeries for aseptic loosening.

SSI that develops into a periprosthetic infection, which can be disastrous.

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