Gaur et al listed criteria for a recurrent infection of an orthopedic device. The authors are from St. Jude's Children Research Hospital in Memphis, Tennessee.
Criteria for a recurrent orthopedic device infection:
(1) history of infection of an orthopedic device, with identification of one or more pathogenic organisms
(2) remission of signs and symptoms with antibiotic therapy, with a symptom free interval afterwards
(3) recurrence of signs and symptoms
(4) identification of one or more of the pathogens previously isolated
Differential diagnosis:
(1) persistent infection (failure to clear with therapy): signs and symptoms recur immediately after discontinuation of antibiotic therapy without a symptom free interval
(2) reinfection: isolation of a new organism not previously identified
Sometimes special testing is done on an isolate (pulse field gel electrophoresis, etc.) to determine if the identical strain of a species is present, or if a new strains is involved.
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