The “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals” protocol adopts the following definition of Bone and Joint Infection (BJ):

 

BJ-BONE: osteomyelitis.

Osteomyelitis must meet at least one of the following criteria:

  • patient has organisms cultured from bone;
  • patient has evidence of osteomyelitis on direct examination of the bone during a surgical operation orhistopathologic examination;
  • patient has at least two of the following signs or symptoms with no other recognised cause: fever (> 38° C), localised swelling, tenderness, heat, or drainage at suspected site of bone infection;

and at least one of the following:

    • organisms cultured from blood;
    • positive blood antigen test (e.g. H. influenzae, S. pneumoniae);
    • radiographic evidence of infection, e.g. abnormal findings on x-ray, CT scan, MRI, radiolabel scan (gallium, technetium, etc.).

A mediastinitis that follows cardiac surgery and that is accompanied by osteomyelitis must be reported as surgical site infection-organ/space (SSI-O).

 

BJ-JNT: joint or bursa.

Joint or bursa infections must meet at least one of the following criteria:

  • patient has organisms cultured from joint fluid or synovial biopsy;
  • patient has evidence of joint or bursa infection seen during a surgical operation or histopathologic examination;
  • patient has at least two of the following signs or symptoms with no other recognised cause: joint pain, swelling, tenderness, heat, evidence of effusion or limitation of motion;

and at least one of the following:

    • organisms and white blood cells seen on Gram’s stain of joint fluid;
    • positive antigen test on blood, urine, or joint fluid;
    • cellular profile and chemistries of joint fluid compatible with infection and not explained by an underlying rheumatologic disorder;
    • radiographic evidence of infection, e.g. abnormal findings on x-ray, CT scan, MRI, radiolabel scan (gallium, technetium, etc.).

 

BJ-DISC: disc space infection.

Vertebral disc space infection must meet at least one of the following criteria:

  • patient has organisms cultured from vertebral disc space tissue obtained during a surgical operation or needle aspiration;
  • patient has evidence of vertebral disc space infection seen during a surgical operation or histopathologic examination;
  • patient has fever (> 38 °C) with no other recognised cause or pain at the involved vertebral disc space and radiographic evidence of infection, e.g. abnormal findings on x-ray, CT scan, MRI, radiolabel scan (gallium, technetium, etc.);
  • patient has fever (> 38 °C) with no other recognised cause and pain at the involved vertebral disc space and positive antigen test on blood or urine (e.g. H. influenzae, S. pneumoniae, N. meningitidis, or Group B Streptococcus).

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Link to European IC/HH Core Competencies

Area 3. Surveillance and investigation of healthcare associated infection (HAI)

References

http://www.ecdc.europa.eu/en/publications/Publications/0512-TED-PPS-HAI-antimicrobial-use-protocol.pdf