"During my four-week period as an observer at the Centre for Musculoskeletal Surgery at Charité University Hospital I had the opportunity to participate in clinical rounds and daily clinical practice in a unique Septic Surgery Unit, where orthopaedics and infectious diseases specialists work together and continuously cooperate in order to optimize the management of bone, soft tissues and prosthetic joint infections. This kind of infections is a major issue worldwide, due to difficulties in obtaining a good and reliable microbiological diagnosis, to choose the best antibiotic treatment and to perform the most appropriate surgical procedure.
During my visit, I learnt how to obtain optimal microbiological samples, choosing the right time for samples’ collection, joint aspiration, and surgery and for selecting the best antibiotic treatment in terms of type of agent, route of administration and duration. I also had the opportunity to participate in consultations, to observe how the team succeeds in managing requests from the various campus of the Charité University Hospital around the city of Berlin and to discuss various clinical scenarios with Dr Trampuz and his team, in a very multidisciplinary and stimulating environment.
Moreover, I took part in the weekly laboratory meetings and spent some days in the research laboratory, where I found a very international and cooperative environment and I had the chance to learn more about some techniques used in in vitro studies on biofilm and PJI infections, such as calorimeter and PCR.
I found a very inspiring, encouraging and well-organized team and, thanks to the PRO-IMPLANT foundation, I even had the great opportunity to join the team in the annual European Congress of Clinical Microbiology and Infectious Diseases in Wien.
Dr Trampuz and his team were always helpful and available for discussion, comparison between different diagnostic and management strategies and translation, making the tough approach to German language softer and constantly involving me in their activities.
I will doubtless translate this experience into my clinical practice. I will pay more attention to sample collection and to samples’ quality and I will try to engage surgeons in active discussions about a combined approach to PJI, taking advantage of the example of optimal interdisciplinary interactions I had. I feel much more confident in the use of antimicrobials for the management of soft tissues, bone and prosthetic infections, knowing better what antibiotic to choose basing on its penetration into tissues and on the necessity to treat and eradicate biofilm in case of device-related infections."
Francesca Giovannenze, Italy