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  1. Article ; Online: Prosthetic joint infection diagnosis in an age of changing clinical patterns of infection and new technologies.

    Davis, Joshua S / Dewar, David / Manning, Laurens

    The Medical journal of Australia

    2024  Volume 220, Issue 5, Page(s) 225–228

    MeSH term(s) Humans ; Arthritis, Infectious ; Arthroplasty, Replacement, Knee ; Prosthesis-Related Infections/diagnosis ; Arthroplasty, Replacement, Hip ; Retrospective Studies
    Language English
    Publishing date 2024-02-13
    Publishing country Australia
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 186082-3
    ISSN 1326-5377 ; 0025-729X
    ISSN (online) 1326-5377
    ISSN 0025-729X
    DOI 10.5694/mja2.52228
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  2. Article ; Online: External Validation of the JS-BACH Classification for Predicting Outcome in Periprosthetic Joint Infections: A Cohort of 653 Patients.

    Kristensen, Nicolai Kjældgaard / Manning, Laurens / Lange, Jeppe / Davis, Joshua S

    The Journal of arthroplasty

    2024  

    Abstract: Background: Periprosthetic Joint Infection (PJI) is a devastating complication in hip and knee joint arthroplasty. The "JS BACH" classification system was developed in 2021 to stratify the complexity of PJI, and more importantly, to act as a tool to ... ...

    Abstract Background: Periprosthetic Joint Infection (PJI) is a devastating complication in hip and knee joint arthroplasty. The "JS BACH" classification system was developed in 2021 to stratify the complexity of PJI, and more importantly, to act as a tool to guide referrals to specialist centers. The "JS BACH" classification has not been validated in an external cohort. This study aimed to do so using a large prospective cohort from Australia and New Zealand.
    Methods: We applied the JS-BACH classification to the Prosthetic Joint Infection in Australia and New Zealand Observational (PIANO) cohort. This prospective study of newly diagnosed PJI collected 2-year outcome data from 653 participants enrolled in 27 hospitals. The definition of PJI treatment failure at 24 months was any of the following: death, clinical or microbiological signs of infection, destination prosthesis removed, or ongoing antibiotic use. Individual cases were classified as per JS-BACH into "1 - uncomplicated" (n = 268), "2 - complex" (n = 330), and "3 - limited options" (n = 55). This cohort was similar to the original JS-BACH population in terms of baseline characteristics. However, there was a difference in complexity, with more DAIR (Debridement, Antibiotics, Implant Retention) procedures, fewer revision procedures, and a higher proportion of uncomplicated patients in the PIANO cohort.
    Results: The risk of treatment failure correlated strongly with the JS-BACH category, with odds ratios (95% CI [confidence interval]) for category 2 versus 1 of 1.75 (1.24 to 2.47) and for category 3 versus 1 of 7.12 (3.42 to 16.02).
    Conclusion: Despite the PIANO study population being less complicated than the original derivation cohort, the JS-BACH classification showed a clear association with treatment failure in this large external cohort.
    Language English
    Publishing date 2024-04-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2024.03.070
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  3. Article ; Online: Association of Posttraumatic Stress Disorder and Race on Readmissions After Stroke.

    Lin, Chen / King, Peter H / Richman, Joshua S / Davis, Lori L

    Stroke

    2024  Volume 55, Issue 4, Page(s) 983–989

    Abstract: Background: There is limited research on outcomes of patients with posttraumatic stress disorder (PTSD) who also develop stroke, particularly regarding racial disparities. Our goal was to determine whether PTSD is associated with the risk of hospital ... ...

    Abstract Background: There is limited research on outcomes of patients with posttraumatic stress disorder (PTSD) who also develop stroke, particularly regarding racial disparities. Our goal was to determine whether PTSD is associated with the risk of hospital readmission after stroke and whether racial disparities existed.
    Methods: The analytical sample consisted of all veterans receiving care in the Veterans Health Administration who were identified as having a new stroke requiring inpatient admission based on the
    Results: Our final cohort consisted of 93 651 patients with inpatient stroke diagnosis and no prior Veterans Health Administration codes for stroke starting from 1999 with follow-up through August 6, 2022. Of these patients, 12 916 (13.8%) had comorbid PTSD. Of the final cohort, 16 896 patients (18.0%) with stroke were readmitted. Our fully adjusted model for readmission found an interaction between African American veterans and PTSD with a hazard ratio of 1.09 ([95% CI, 1.00-1.20]
    Conclusions: Among African American veterans who experienced stroke, preexisting PTSD was associated with increased risk of readmission, which was not significant among White veterans. This study highlights the need to focus on high-risk groups to reduce readmissions after stroke.
    MeSH term(s) Humans ; United States/epidemiology ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/diagnosis ; Retrospective Studies ; Patient Readmission ; Stroke/epidemiology ; Stroke/therapy ; Comorbidity ; Veterans
    Language English
    Publishing date 2024-03-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.123.044795
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    Zs.A 448: Show issues Location:
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  4. Article ; Online: Creating concise and readable patient information sheets for interventional studies in Australia: are we there yet?

    Symons, Tanya / Davis, Joshua S

    Trials

    2022  Volume 23, Issue 1, Page(s) 794

    Abstract: Background: Participant information sheets and consent forms (PICFs) used in interventional studies are often criticised for being hard to read and understand. We assessed the readability and its correlates of a broad range of Australian PICFs.: ... ...

    Abstract Background: Participant information sheets and consent forms (PICFs) used in interventional studies are often criticised for being hard to read and understand. We assessed the readability and its correlates of a broad range of Australian PICFs.
    Methods: We analysed the participant information sheet portion of 248 PICFs. Readability scores were measured using three formulae: the Flesch Reading Ease, the Flesch-Kincaid Grade Level, and the Simple Measure of Gobbledygook (SMOG). We investigated how various features (including sponsor type and PICF type) correlated with PICF length and readability and examined compliance with other measures known to improve readability.
    Results: For a sample of 248 PICFs, the mean (standard deviation) Flesch Reading Ease score was 49.3 (5.7) and for the Flesch-Kincaid Grade Level 11.4 (1.1). The mean (SD) SMOG score was 13.2 (0.9). The median document length was 3848 words (8 pages). Commercial PICFs were more than twice as long as non-commercial, but statistically more readable (p = 0.03) when analysed using the SMOG formula. Subgroup analyses indicated that PICFs for self-consenters were statistically more readable than those for proxy consenters. The use of tables, but not the use of illustrations was associated with better readability scores.
    Conclusions: The PICFs in our sample are long and complex, and only 3 of the 248 achieved the recommended readability score of grade 8 or below. The broader use of best practice principles for writing health information for consumers and the development of more context-sensitive templates could improve their utility.
    MeSH term(s) Australia ; Comprehension ; Consent Forms ; Humans ; Internet ; Reading ; Smog
    Chemical Substances Smog
    Language English
    Publishing date 2022-09-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2040523-6
    ISSN 1745-6215 ; 1468-6694 ; 1745-6215
    ISSN (online) 1745-6215
    ISSN 1468-6694 ; 1745-6215
    DOI 10.1186/s13063-022-06712-z
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  5. Article ; Online: Common orthopaedic trauma may explain 31,000-year-old remains.

    Murphy, Nicholas J / Davis, Joshua S / Tarrant, Seth M / Balogh, Zsolt J

    Nature

    2023  Volume 615, Issue 7952, Page(s) E13–E14

    MeSH term(s) Humans ; Infant, Newborn ; Orthopedics ; Borneo ; Fractures, Bone/surgery ; Amputation, Surgical ; Extremities
    Language English
    Publishing date 2023-03-15
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 120714-3
    ISSN 1476-4687 ; 0028-0836
    ISSN (online) 1476-4687
    ISSN 0028-0836
    DOI 10.1038/s41586-023-05756-8
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  6. Article ; Online: Have gloves and gowns had their day? An Australian and New Zealand practice and attitudes survey about contact precautions for MRSA and VRE colonisation.

    Browning, Sarah / Davis, Joshua S / Mitchell, Brett G

    Infection, disease & health

    2023  Volume 28, Issue 3, Page(s) 221–225

    Abstract: Background: 'Contact precautions,' are recommended for hospitalised patients with known methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) colonisation. Despite increasing observational evidence suggesting that ...

    Abstract Background: 'Contact precautions,' are recommended for hospitalised patients with known methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) colonisation. Despite increasing observational evidence suggesting that gowns and gloves are of no added benefit over hand hygiene and environmental cleaning, guidelines continue to recommend them.
    Methods: A cross-sectional online survey of infection prevention professionals, infectious diseases physicians and microbiologists in Australian and New Zealand hospitals was conducted. The purpose was to explore variations in current approaches to known MRSA and VRE colonisation, and determine clinical equipoise for a proposed randomised control trial (RCT) to withdraw the use of gowns and gloves in this setting.
    Results: 226 responses from 122 hospitals across all Australian jurisdiction and multiple regions of New Zealand were received. While most hospitals implement contact precautions for MRSA (86%) and VRE (92%), variations based on MRSA and VRE subtypes are common. There was strong interest in removing glove and gown use for MRSA (72% and 73%, respectively) and VRE (70% and 68%, respectively). 62% of surveyed hospitals expressed interest in participating in a proposed cluster RCT comparing discontinuation of gown and glove use as part of contact precautions for MRSA and VRE, with their ongoing use.
    Conclusion: The mandated use of PPE in the context of MRSA and VRE colonisation warrants further examination. An RCT is needed to definitively address this issue and to promote a widespread change in practice, if warranted.
    MeSH term(s) Humans ; Methicillin-Resistant Staphylococcus aureus ; Vancomycin-Resistant Enterococci ; Cross Infection/prevention & control ; Staphylococcal Infections/prevention & control ; New Zealand ; Gloves, Protective ; Australia
    Language English
    Publishing date 2023-04-15
    Publishing country Netherlands
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2902143-1
    ISSN 2468-0869 ; 2468-0451
    ISSN (online) 2468-0869
    ISSN 2468-0451
    DOI 10.1016/j.idh.2023.03.006
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  7. Article ; Online: Optimal drug therapy for Staphylococcus aureus bacteraemia in adults.

    Legg, Amy / Davis, Joshua S / Roberts, Jason A

    Current opinion in critical care

    2023  Volume 29, Issue 5, Page(s) 446–456

    Abstract: ... abscesses. Mortality from S. aureus bacteraemia remains high, without major therapeutic advances in recent ... recognized as a cornerstone of management for severe infections including S. aureus bacteraemia ... This review details the different PK/PD targets for drugs used to treat S. aureus bacteraemia and how to apply ...

    Abstract Purpose of review: Staphylococcus aureus is a significant human pathogen, causing a variety of infections, from skin and soft tissue infections to endocarditis, bone and joint infections and deep tissue abscesses. Mortality from S. aureus bacteraemia remains high, without major therapeutic advances in recent decades.
    Recent findings: In recent years, optimized dosing of antibiotics is increasingly being recognized as a cornerstone of management for severe infections including S. aureus bacteraemia. This comprehensive review details the pharmacokinetics/pharmacodynamics (PK/PD) targets for commonly used antistaphylococcal antibiotics and the doses predicted to achieve them in clinical practice. Recent advances in dosing of teicoplanin and use of cefazolin in CNS infections and findings from combination therapy studies are discussed. Drug exposure relationships related to toxicity are also detailed.
    Summary: This review details the different PK/PD targets for drugs used to treat S. aureus bacteraemia and how to apply them in various scenarios. The drug doses that achieve them, and the risks of toxicity are also provided.
    MeSH term(s) Adult ; Humans ; Staphylococcal Infections/drug therapy ; Bacteremia/drug therapy ; Staphylococcus aureus ; Cefazolin ; Anti-Bacterial Agents/therapeutic use
    Chemical Substances Cefazolin (IHS69L0Y4T) ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-07-27
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000001072
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  8. Article: Design Characteristics and Recruitment Rates for Randomized Trials of Peri-Prosthetic Joint Infection Management: A Systematic Review.

    Manning, Laurens / Allen, Bethwyn / Davis, Joshua S

    Antibiotics (Basel, Switzerland)

    2023  Volume 12, Issue 10

    Abstract: Prosthetic joint infections (PJI) present a major management challenge for practicing orthopedic surgeons and infectious disease physicians. There are few high-quality data to inform treatment guidelines. The aim of this systematic review was to report ... ...

    Abstract Prosthetic joint infections (PJI) present a major management challenge for practicing orthopedic surgeons and infectious disease physicians. There are few high-quality data to inform treatment guidelines. The aim of this systematic review was to report the design characteristics and recruitment rates for randomized controlled trials (RCTs) of PJI management. Trials were considered eligible for inclusion if human participants were randomized to any management intervention for PJI. We searched Medline, PubMed, Embase, Web of Science, Cochrane Database, ANZ Clinical Trials Registry, ClinicalTrials.gov, and the EU Clinical Trials Register until the end of May 2023. The systematic review was registered with PROSPERO (CRD42018112646). We identified 15 published RCTs with a total of 1743 participants with PJI. The median (interquartile range [IQR]) number of successfully recruited participants was 63 (38-140), with 0.28 (0.13-0.96) enrolments per site per month. Only four trials (36.4%) achieved the target recruitment. All RCTs applied different primary endpoints and varying definitions of a 'good' outcome. Despite recent improvements, PJI RCTs are characterized by slow recruitment and heterogeneous endpoint assessments, which preclude synthesis in a standard meta-analytic framework. To inform international guidelines, future PJI trials should be run as multi-country trials at high-recruiting sites.
    Language English
    Publishing date 2023-09-27
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics12101486
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  9. Article ; Online: Correct Calculation of Confidence Interval for Proportion of Superior Comparisons Between Desirability of Outcome Ranking Scores.

    Loewenthal, Mark R / Davis, Joshua S / Dymock, Michael

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2022  Volume 76, Issue 1, Page(s) 175–176

    Language English
    Publishing date 2022-11-15
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciac348
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  10. Article ; Online: Addressing important evidence gaps in the management of prosthetic joint infection: clinician attitudes and equipoise.

    Isler, Burcu / Niessen, Natalie / Campbell, David / Toms, Andrew D / Daneman, Nick / Manning, Laurens / Davis, Joshua S

    ANZ journal of surgery

    2024  

    Language English
    Publishing date 2024-03-30
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/ans.18984
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