About this Research Topic
Prosthetic Joint Infection (PJI) is an important healthcare problem which affects 1-2% of patients undergoing prosthetic surgery, having become the most common reason for early revisions after knee arthroplasty and the second most common reason after hip arthroplasty. PJI causes enormous suffering, it is associated with a mortality being higher than in some cancer, such as prostate or breast malignancies, and costs for healthcare often exceed 100.000 € per affected patient.
The main causative and differentiating factor related to PJI is microorganisms’ ability to form a biofilm, which confers high resistance to antibiotics and to host immune response. Thus, this implies a difficulty in combating it, the ineffectiveness of many antibiotics and, in most cases, the need for prosthesis exchange.
Despite recent advances in prevention and treatment, there is still an urgent need to enhance our basic understanding of the pathophysiology and to improve clinical success rates. Different surgical treatments have been proposed, such as radical debridement, one or two stage or even resection arthroplasty, combined with different antibiotic protocols (short duration, long duration, suppression treatment…). Recent studies show success rates of around 70% with current treatment strategies. In this discouraging scenario, we aim to deeply search for novel and outstanding results that help us better understand the pathogenesis of PJI and search for new strategies to combat PJI.
In the current Research Topic, we aim to include original articles and reviews regarding the following research fields:
1. Pathogenesis of PJI: the role of biofilm and extracellular matrix development.
2. Development of antimicrobial resistance by transfer of resistance genes: Relevant for outcomes in PJI?
3. Host-pathogen interactions and novel preventive strategies.
4. Drug holiday in two-stage revisions: Improved diagnostics, but increased risk of relapse?
6. Advances in therapeutics:
• Is Rifampicin really the only "anti-biofilm" antibiotic, or do we have alternatives?
• Phage therapy: The new wonder-drug for PJI?
The main causative and differentiating factor related to PJI is microorganisms’ ability to form a biofilm, which confers high resistance to antibiotics and to host immune response. Thus, this implies a difficulty in combating it, the ineffectiveness of many antibiotics and, in most cases, the need for prosthesis exchange.
Despite recent advances in prevention and treatment, there is still an urgent need to enhance our basic understanding of the pathophysiology and to improve clinical success rates. Different surgical treatments have been proposed, such as radical debridement, one or two stage or even resection arthroplasty, combined with different antibiotic protocols (short duration, long duration, suppression treatment…). Recent studies show success rates of around 70% with current treatment strategies. In this discouraging scenario, we aim to deeply search for novel and outstanding results that help us better understand the pathogenesis of PJI and search for new strategies to combat PJI.
In the current Research Topic, we aim to include original articles and reviews regarding the following research fields:
1. Pathogenesis of PJI: the role of biofilm and extracellular matrix development.
2. Development of antimicrobial resistance by transfer of resistance genes: Relevant for outcomes in PJI?
3. Host-pathogen interactions and novel preventive strategies.
4. Drug holiday in two-stage revisions: Improved diagnostics, but increased risk of relapse?
6. Advances in therapeutics:
• Is Rifampicin really the only "anti-biofilm" antibiotic, or do we have alternatives?
• Phage therapy: The new wonder-drug for PJI?
Keywords: Prosthetic Joint Infection, PJI, biofilm, arthroplasty, debridement, preventive strategies, antibiotics, phage therapy
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