ArticleAntibiotics (Basel, Switzerland)2022
Causative Pathogens Do Not Differ between Early, Delayed or Late Fracture-Related Infections.
Article in Antibiotics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Antibiotic Selection for Sustained Local Therapy May Be Important to ReduceMicroorganisms · 2026Article
- MRSA-dominant colonization and synergistic pathogenicity withJournal of orthopaedic translation · 2026Article
- Decoding resistance: a comprehensive study on pathogens and antibiotic efficacy in periprosthetic joint infections.Journal of orthopaedic surgery and research · 2026Article
- In vivo bacteria-targeted imaging with vancomycin-based positron emission tomography and optical tracers in an orthopaedic trauma implant infection model.European journal of nuclear medicine and molecular imaging · 2026Article
- Clinical Outcome After Surgery for Fracture-Related Infection Is Dependent on Both Microbiology and the Host Inflammatory Response.Pathogens (Basel, Switzerland) · 2026Article
- Strategic considerations in the treatment of infected nonunion in the lower extremity: a narrative review.International journal of surgery (London, England) · 2026Article
- Sonication versus peri-implant tissue culture in fracture-related infection: diagnostic performance and therapeutic consequences in a single-center cohort.Journal of bone and joint infection · 2026Article
- Diagnosis and management of fracture-related infections in a low-income country: a prospective study comparing current practice to international consensus guidelines.Journal of bone and joint infection · 2026Article
- Management of fracture-related infection in low-resource settings in Africa: recommendations and guidelines from an international expert group.Journal of bone and joint infection · 2026Article
- Exploring the Value of Paired Microbiology and Histology in Chronic Osteomyelitis and Fracture-Related Infections.Antibiotics (Basel, Switzerland) · 2025Article
- Is routine Gram-negative antibiotic coverage required for optimum antibiotic prophylaxis in open reduction and internal fixation of fractures? A multicenter analysis of bacteria pathogens in fracture-related infections.Musculoskeletal surgery · 2025Article
- Assessing the efficacy of systemic antibiotics for biofilm-associated infection in an ovine model of simulated fracture-related infection.Journal of bone and joint infection · 2025Article
- A Comparison of Causative Pathogens in Bone and Prosthetic Joint Infections: Implications for Antimicrobial Therapy.Antibiotics (Basel, Switzerland) · 2024Article
- Pathogens in FRI - Do bugs matter? - An analysis of FRI studies to assess your enemy.Journal of orthopaedics · 2024Article
- The Microbiological Profile and Antibiotic Susceptibility of Fracture Related Infections in a Low Resource Setting Differ from High Resource Settings: A Cohort Study from Cameroon.Antibiotics (Basel, Switzerland) · 2024Article
- Fracture-Related Infection-Epidemiology, Etiology, Diagnosis, Prevention, and Treatment.Deutsches Arzteblatt international · 2024Review
- Fracture-Related Infection-Epidemiology, Etiology, Diagnosis, Prevention, and Treatment.Deutsches Arzteblatt international · 2024Review
- Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre.Antibiotics (Basel, Switzerland) · 2023Article
- Antibiotic-Loaded Coatings to Reduce Fracture-Related Infections: Retrospective Case Series of Patients with Increased Infectious Risk.Antibiotics (Basel, Switzerland) · 2023Article
- Current Concepts of Fracture-Related Infection.International journal of clinical practice · 2023Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fracture-related infections (FRIs) are classically considered to be early (0−2 weeks), delayed (3−10 weeks) or late (>10 weeks) based on hypothesized differences in causative pathogens and biofilm formation. Treatment strategies often reflect this classification, with debridement, antimicrobial therapy and implant retention (DAIR) preferentially reserved for early FRI. This study examined pathogens isolated from FRI to confirm or refute these hypothesized differences in causative pathogens over time. Cases of FRI managed surgically at three centres between 2015−2019 and followed up for at least one year were included. Data were analysed regarding patient demographics, time from injury and pathogens isolated. Patients who underwent DAIR were also analysed separately. In total, 433 FRIs were studied, including 51 early cases (median time from injury of 2 weeks, interquartile range (IQR) of 1−2 weeks), 82 delayed cases (median time from injury of 5 weeks, IQR of 4−8 weeks) and 300 late cases (median time from injury of 112 weeks, IQR of 40−737 weeks). The type of infection was associated with time since injury; early or delayed FRI are most likely to be polymicrobial, whereas late FRIs are more likely to be culture-negative, or monomicrobial. Staphylococcus aureus was the most commonly isolated pathogen at all time points; however, we found no evidence that the type of pathogens isolated in early, delayed or late infections were different (p = 0.2). More specifically, we found no evidence for more virulent pathogens (S. aureus, Gram-negative aerobic bacilli) in early infections and less virulent pathogens (such as coagulase negative staphylococci) in late infections. In summary, decisions on FRI treatment should not assume microbiological differences related to time since injury. From a microbiological perspective, the relevance of classifying FRI by time since injury remains unclear.
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