Antonia Scobie edtDr. Antonia Scobie, a microbiologist from London, UK, was an ESCMID observer at Charité - University Medicine Berlin.

Here her feedback:

"I have learned a new approach to diagnosing prosthetic joint infection using a combination of clearly defined clinical and pathological criteria such as histology, synovial white cell count and microbiological culture results. This will help in my clinical practice for deciding on whether to treat cases of prosthesis loosening or suspected infection in complicated or unclear cases.

I have gained experience of the process of sonication of whole prostheses by observing the processing of samples in the laboratory and some of the issues that can arise with sonication such as potential contamination of samples if the containers are damaged. As our laboratory in St George’s Hospital will start sonication soon, I have incorporated some of the processes employed in the laboratory in Berlin into our SOP to enable the optimal sonication process.

Along with laboratory experience I have also gained exposure to the interpretation of sonication results in the clinical setting of deciding whether a result is clinically significant or represents contamination.
Through attendance of the daily ward rounds and reviewing patients in the outpatient clinic, I have learned of a different approach to treating prosthetic joint infection such as using two weeks of intravenous therapy (in Charité) compared with six weeks, which we would commonly use in the UK. Given that patients do seem to have good clinical outcomes with shorter intravenous durations and less potential toxicity, this experience will make me review the antibiotic durations we routinely advocate.
Having attended a two day workshop on diagnosis and management of implant associated and prosthetic joint infections and the management of "difficult to treat" infections – I feel more confident in the management of future cases of these.
Overall, all the staff in the department were very accommodating and friendly and tried to speak English with me whenever possible. I very much enjoyed this experience and would recommend it to others."

Antonia Scobie, UK

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