肌肉骨骼感染(MSKI),这是骨科的一个主要问题,当病原体逃避或淹没宿主免疫系统时发生。虽然预防和治疗MSKI的有效疫苗和免疫疗法应该是可能的,我们对保护性理解的基本知识差距,非保护性,和致病性宿主免疫是禁止的。我们也缺乏关于宿主免疫如何受微生物组影响的关键知识,植入物,先前的感染,营养,抗生素,和伴随的治疗,自身免疫,和其他合并症。为了定义我们对这些关键主题的当前知识,a2023年骨科研究学会MSKI国际共识会议(ICM)的宿主免疫部分提出了78个问题。对其中15个问题进行了系统评价,72名ICM代表对具有证据水平的建议进行了投票,另外12个问题以“未知”的建议进行了投票,没有进行系统审查。两个问题被转移到另一个ICM科,由于现有人力资源的限制,其他45份提交供今后审议。在这里,我们通过互联网访问问题来报告投票的结果,recommendations,以及系统评价的基本原理。18个问题获得了≥90%的共识投票,而九项建议未能达到这一门槛。关于为什么在这些问题上没有达成共识的评论,并提供了潜在的前进方向,以刺激对这些关键的MSKI主机防御问题的特定资助机制和研究。
Musculoskeletal infections (MSKI), which are a major problem in orthopedics, occur when the pathogen eludes or overwhelms the host immune system. While effective vaccines and immunotherapies to prevent and treat MSKI should be possible, fundamental knowledge gaps in our understanding of protective, nonprotective, and pathogenic host immunity are prohibitive. We also lack critical knowledge of how host immunity is affected by the microbiome, implants, prior infection, nutrition, antibiotics, and concomitant therapies, autoimmunity, and other comorbidities. To define our current knowledge of these critical topics, a Host Immunity Section of the 2023 Orthopaedic Research Society MSKI International Consensus Meeting (ICM) proposed 78 questions. Systematic reviews were performed on 15 of these questions, upon which recommendations with level of evidence were voted on by the 72 ICM delegates, and another 12 questions were voted on with a recommendation of \"Unknown\" without systematic reviews. Two questions were transferred to another ICM Section, and the other 45 were tabled for future consideration due to limitations of available human resources. Here we report the results of the voting with internet access to the questions, recommendations, and rationale from the systematic reviews. Eighteen questions received a consensus vote of ≥90%, while nine recommendations failed to achieve this threshold. Commentary on why consensus was not achieved on these questions and potential ways forward are provided to stimulate specific funding mechanisms and research on these critical MSKI host defense questions.