Bone and joint infections of the hand.,Clinical Microbiology and Infection

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Bone and joint infections of the hand.
Clinical Microbiology and Infection ( IF 10.9 ) Pub Date : 2020-01-07 , DOI: 10.1016/j.cmi.2019.12.007
P Sendi ₁ , A Kaempfen ₂ , I Uçkay ₃ , R Meier ₄

Affiliation

Background

Little guidance is currently available for standardized diagnostic protocols and therapeutic recommendations for bone and joint infections (BJIs) of the hand.

Objectives

To summarize the available data in the scientific English-language literature on the diagnosis and treatment of native BJIs of the hand. To illustrate these concepts from a narrative point of view in areas where there is lack of evidence.

Sources

We performed a systematic PubMed and Internet search of studies that investigated hand BJIs in adult patients.

Content

Few studies have systematically investigated and validated diagnostic concepts, classifications or surgical treatment protocols. Most concepts derive from traditional intra-institutional experience, expert opinions and extrapolations from infections in large joints and long bones. Similarly, there is no uniformly accepted infection definition of BJIs of the hand. The best-documented literature is available for microbiological findings and antibiotic treatment duration in uncomplicated native joint arthritis of the fingers. Retrospective studies and one prospective randomized trial suggest that post-surgical targeted antibiotic therapy of 2 weeks results in a microbiological cure rate of ≥88%.

Implications

Studies on diagnostic workup and infection definition and classification are urgently needed to compare inter-institutional outcome results and generate guidelines for the best patient care. For uncomplicated pyogenic arthritis of native joints, current evidence suggests that a 2-week course of antibiotic therapy following surgery cures the infection.

中文翻译：

手的骨和关节感染。

背景

目前对于手部的骨和关节感染（BJI）的标准化诊断方案和治疗建议的指导很少。

目标

总结科学英语文献中有关手部本地BJI的诊断和治疗的可用数据。在缺乏证据的地方从叙述的角度说明这些概念。

资料来源

我们进行了系统的PubMed和Internet搜索，以研究成年患者手部BJI。

内容

很少有研究系统地研究和验证诊断概念，分类或手术治疗方案。大多数概念源自传统的机构内经验，专家意见以及大关节和长骨感染的推断。同样，也没有统一接受的手部BJI感染定义。对于无并发症的手指自然关节关节炎的微生物学发现和抗生素治疗的持续时间，有最好的文献记载。回顾性研究和一项前瞻性随机试验表明，术后2周的靶向抗生素治疗可使微生物治愈率≥88％。