Transcript The Bone & Joint Program at the University of Louisville

The Bone & Joint Program at the University of Louisville:
The Bone and Joint Infection (BAJIO) Database
Diana Christensen MD, Julie Harting PharmD, Cheick Mariko CRC, Robert Kelley PhD,
Timothy Wiemken PhD and Julio Ramirez MD.
Division of Infectious Diseases, University of Louisville Hospital, Louisville, KY.
Osteomyelitis is a common costly clinical
problem.
 Despite important medical and surgical
advances in management of patients,
osteomyelitis remains extremely difficult to
treat. The relapse rate can be 20%. [1]
Challenges to osteomyelitis treatment include
difficulty identifying the offending pathogen ,
the necessity for surgical debridement and a
prolonged course of intravenous (IV)
therapy.[2-5]
The objective of this study was to describe the
Bone and Joint program at the University of
Louisville.
METHODS
In the Division of Infectious Diseases at the
University of Louisville, we have developed a
team dedicated only to skin & soft tissue
infections (SSTI) and osteomyelitis.
This team includes an infectious diseases
attending, an infectious diseases fellow, a
clinical pharmacist and a clinical research
coordinator.
Our team provides care during the
hospitalization of patients with SSTI & bone
infections.
After discharge we follow patients requiring
PICC lines and IV antibiotics with weekly labs
as well as follow up visits for all patients in our
clinic 4-6 weeks after discharge (end of IV
therapy), one month after discontinuation of
IV antibiotics , 3-6 and 12 months after
treatment.
CONCLUSIONS
RESULTS
INTRODUCTION
At this time we have evaluated 620 inpatients consults and 2860 follow-ups during the period
July 2011-June 2013.
Our multidisciplinary approach to this complex disease is represented in Figure 1.
We teach to medical students, pharmacy students, residents, and fellows.
We have created a database called BAJIO that currently has 300 patients with diagnosis of
osteomyelitis, prosthetic joint infections and septic arthritis.
We have three published articles ( pictures are shown ) , two in preparation, one accepted
grant and a prospective study in preparation.
We are presenting six posters at Research Louisville and one poster accepted at IDSA.
PODIATRY
ORTHOPEDIC
SURGERY
VASCULAR
INFECTIOUS
DISEASES
PHARMACY
HOME
INFUSION
COMPANIES
FIGURE 1:THE MULTIDISCIPLINARY GROUP
PUBLISHED ARTICLES
 The success of our group relies on a
multidisciplinary, collaborative approach with
orthopedics, podiatry, plastic surgery, oral and
maxillofacial surgery, vascular surgery,
microbiology, pathology, pharmacy, and home
infusion companies.
✪ We dedicate our efforts to improving patient
outcomes and medical training as well as increasing
opportunities for research, publication and grants.
REFERENCES
1- Mandell, G. Principles and Practice of Infectious
Diseases. Volume 1. Chapter 103.
OSTEOMYELITIS
MICROBIOLOGY
 The Bone and Joint program at the University of
Louisville is a growing program with expertise in
skin & soft tissue infections and osteomyelitis.
2- Lavery LA, Armstrong DG, Peters EJ, Lipsky BA.
Probe-to-bone test for diagnosing diabetic foot
osteomyelitis: reliable or relic? Diabetes Care. 2007;
30(2): 270–4. doi: 10.2337/dc06-1572.
3- Lazzarini L, Lipsky BA, Mader JT. Antibiotic
treatment of osteomyelitis: what we have learned
from 30 years of clinical trials? Int J Infect Dis
2005;9:127-38
4- Rod-Fleury T, Dunkel N, Assal M, et al. Duration of
post surgical antibiotic therapy for adult chronic
osteomyelitis: a single center experience.
5- Uckay I, Jugun K. Chronic Osteomyelitis. Curr Infect
Dis Rep(2012);14:566-575.