Jenny Aronson

All Publications

• Antibiotic Duration after Debridement and Implant Retention for Early Postoperative Spinal Implant Infections: A Multicenter Cohort Study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Tai, D. B., Poehlein, E., O'Neil, J. C., Nelson, S. B., Tande, A. J., Corvino, D. D., Ritter, A. S., Aronson, J., Certain, L., Furukawa, D., Tatara, A. M., Green, C. L., Abdalla, T., Fleece, M. E., Tobert, D. G., Erickson, M., Seidelman, J. 2026

  Abstract

  Postoperative spinal implant infections (PSII) are a serious complication of instrumented spinal fusion. Although debridement with implant retention is standard for early infection, the optimal duration of antimicrobial therapy remains uncertain.We conducted a multicenter retrospective cohort study across ten U.S. academic centers, including adults with early PSII (≤90 days after fusion surgery) from 2017 to 2021. We excluded patients who experienced treatment failure within 6 weeks of debridement. The primary outcome was treatment failure. Antibiotic therapy effect was analyzed as a time-varying exposure using adjusted Cox proportional hazards models. Secondary analyses included 12-week landmark and clone-censor-weighted models to compare durations ≤12 weeks versus >12 weeks.116 patients out of 499 (23.2%) experienced treatment failure during a median follow-up of 3.2 years. Among patients who remain failure-free six weeks from debridement, being on antibiotics was not associated with treatment failure (adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.48-1.07; p = 0.10). In a 12-week landmark analysis limited to 359 patients who were not on indefinite suppressive antibiotic therapy, treatment durations >12 weeks did not significantly reduce the risk of failure (aHR 1.01, 95% CI 0.62-1.64; p = 0.99). Results were consistent in the clone-censor-weight sensitivity analysis (aHR 0.85, 95% CI 0.62-1.16; p = 0.30).Prolonged antibiotic therapy was not associated with improved outcomes in early PSII managed with debridement and implant retention. These results support shorter, individualized antibiotic courses in patients with adequate surgical source control.

  View details for DOI 10.1093/cid/ciag300

  View details for PubMedID 42084484

• Osteoarticular Coccidioidomycosis in California: A Single-Center Experience. Open forum infectious diseases Arya, R., Dzinoreva, M., Shiu, T., Thottacherry, E., Chang, A., Aronson, J., Kappagoda, S., Furukawa, D. 2026; 13 (3): ofag103

  Abstract

  Osteoarticular involvement in coccidioidomycosis is an uncommon manifestation leading to significant morbidity, but evidence surrounding it is limited. We aimed to describe the clinical characteristics of osteoarticular coccidioidomycosis and identify factors associated with treatment failure.We performed a retrospective chart review of adults age ≥18 years hospitalized with confirmed osteoarticular coccidioidomycosis at an academic tertiary care center between 2004 and 2021. We extracted demographic, clinical, microbiologic, treatment, and outcomes data. Univariable regression analysis was used to identify risk factors of disease progression or relapse.Thirty-two patients were reviewed, of whom 29 (91%) were male, with a median age (interquartile range [IQR]) of 46.8 (35.1-65.6) years and a median time of follow-up (IQR) of 84 (47-127) months. The most common sites of infection were spine (n = 15, 47%) and knee (n = 9, 28%). Itraconazole was the most common antifungal used (n = 16, 50%), followed by posaconazole (n = 8, 25%), and surgery was performed in 24 (75%) patients. The median treatment duration (IQR) was 45.0 (13.3-66.7) months, with 26 (81%) patients remaining on antifungals through the last day of follow-up. Fifteen (47%) patients experienced progression and/or relapse. Knee (odds ratio [OR], 18.29; 95% CI, 91-175.35) and multisite infections (OR, 6.56; 95% CI, 1.10-39.32) were associated with disease progression and/or relapse, while spine infection was associated with lower rates of progression and/or relapse (OR, 0.20; 95% CI, 0.44-0.90).Patients with osteoarticular coccidioidomycosis required prolonged therapy with a substantial risk of disease progression or relapse. Knee and multisite infections were associated with poorer outcomes. Larger studies are needed to validate these findings and optimize treatment strategies.

  View details for DOI 10.1093/ofid/ofag103

  View details for PubMedID 41822370

  View details for PubMedCentralID PMC12978523

• 2025 ICM: Immune Status. The Journal of arthroplasty Whitmarsh-Brown, M. A., Helton, A., Al Farli, H., Aronson, J. R., Dobarganes Barlow, F. G., Cichos, K. H., Reyes Copello, J. F., Gililland, J., Jiranek, W., Langsfeld, J., Tanavalee, A. 2025

  View details for DOI 10.1016/j.arth.2025.10.097

  View details for PubMedID 41176115

• 2025 ICM: Immunocompromised Patients and Polymicrobial Agents. The Journal of arthroplasty Ugalde, H. G., Tootsi, K., Abdelazeem, A. H., Aronson, J. R., Da Rin de Lorenzo, F., Bonilla León, G. A., Sebastian, S., Sober-Williams, E. K., Tsiridis, E., Wouthuyzen-Bakker, M., Ya'ish, F., Zeller, V. 2025

  View details for DOI 10.1016/j.arth.2025.10.109

  View details for PubMedID 41176108

• Local Antibiotic Delivery in Orthopedics: Review of Current Practices and Emerging Technologies. Infectious disease clinics of North America Aronson, J. R., Justo, J. A., Amanatullah, D. F. 2025

  Abstract

  This article explores the role of local antibiotic delivery in the management of orthopedic infections, a significant challenge in modern healthcare. This article delineates between prophylactic and therapeutic uses of antibiotics, examining various delivery methods, including topical powders, irrigation solutions, intraosseous injections, and antibiotic-loaded bone cement. While local administration aims to enhance therapeutic efficacy and minimize systemic exposure, there is limited evidence supporting effectiveness. The article aims to review the current practices and evidence and highlight emerging strategies such as hydrogels and biodegradable systems. Ongoing research is essential to optimize these methods and improve patient outcomes in orthopedic care.

  View details for DOI 10.1016/j.idc.2025.03.002

  View details for PubMedID 40410075

• Implementing Oral Antibiotics for Bone and Joint Infections: Lessons Learned and Opportunities for Improvement. Open forum infectious diseases Hawkins, M. R., Thottacherry, E., Juthani, P., Aronson, J., Chang, A., Amanatullah, D. F., Markovits, J., Shen, S., Holubar, M., Andrews, J. R., Parsonnet, J., Furukawa, D. 2024; 11 (12): ofae683

  Abstract

  Although intravenous antibiotics have historically been the standard of care for bone and joint infections, clinical trial data have highlighted the safety and efficacy of oral antibiotics. Despite this, intravenous antibiotics are still commonly used, and evaluations of institutional guidelines advancing oral antibiotic use are limited.In April 2023, we implemented a new institutional guideline to preferentially treat patients with bone and joint infections with oral antibiotics. The postguideline cohort was compared with a historical preguideline cohort via retrospective chart review. The primary outcome was the proportion of patients discharged exclusively on oral antibiotics. Secondary outcomes included 90-day treatment failure, length of stay, and adverse effects.One hundred eighty-six patients (53 preguideline and 133 postguideline) were included in the analysis. Patients in the postguideline cohort were more likely to be discharged exclusively on oral antibiotics (25% vs 70%; P < .01), with no difference in 90-day treatment failure (8% vs 9%; P = .75). Patients in the postguideline cohort had a shorter length of stay than preguideline (median, 8 vs 7 days; P = .04) and trended toward fewer peripherally inserted central catheter-related adverse events (6% vs 1%; P = .07).An institutional guideline was effective in increasing the proportion of patients with bone and joint infections discharged on oral antibiotics. We observed similar clinical outcomes after implementing the guidelines while reducing length of hospital stay.

  View details for DOI 10.1093/ofid/ofae683

  View details for PubMedID 39660026

  View details for PubMedCentralID PMC11629981

• A Case of Persistent Intra-Abdominal Stenotrophomonas maltophilia Infection Despite Bacteriophage Therapy. PHAGE (New Rochelle, N.Y.) Cullen, G. D., Salazar, K. C., Terwilliger, A. L., Aslam, S., Clark, J. R., Maresso, A. W., Bollyky, P. L., Aronson, J. R. 2024; 5 (3): 120-125

  Abstract

  Multidrug resistant infections are a challenge in the health care setting and a cause of patient morbidity and mortality. Bacteriophages (phages) are viruses that target and kill bacteria and have been used in patients to treat bacterial infections. We present a case of disseminated Stenotrophomonas maltophilia infection, with pulmonary, intra-abdominal and bloodstream involvement. The patient was treated with a combination of antibiotics and personalized phage therapy, administered daily for 12 days both intravenously as well as via intra-abdominal drains. Phage therapy was well-tolerated, the patient cleared S. maltophilia from their bloodstream and their intra-abdominal abscesses were stable or decreased in size. However, the intra-abdominal fluid cultures remained positive for S. maltophilia. Unfortunately, the patient passed away 2 months after completion of phage therapy due to multiorgan failure. These data highlight the difficulty of treating critically ill patients and clearing complex, biofilm mediated infections, even with phages. More information is needed regarding the optimal treatment protocols for phage therapy in complex multifocal infections.

  View details for DOI 10.1089/phage.2023.0034

  View details for PubMedID 39372359

  View details for PubMedCentralID PMC11447384

• No differences in outcomes with stopping or continuing antibiotic suppression in periprosthetic joint infections. Journal of bone and joint infection Furukawa, D., Dunning, M., Shen, S., Chang, A., Aronson, J., Amanatullah, D. F., Suh, G. A., Kappagoda, S. 2024; 9 (3): 143-148

  Abstract

  The data on long-term antibiotic use following debridement, antibiotics, and implant retention (DAIR) for treatment of periprosthetic joint infections are limited. In this single-center retrospective study, we show that patients with eventual cessation of antibiotic suppression after DAIR had similar outcomes to those who remained on chronic antibiotic suppression.

  View details for DOI 10.5194/jbji-9-143-2024

  View details for PubMedID 38899055

  View details for PubMedCentralID PMC11184613

• The Safety and Toxicity of Phage Therapy: A Review of Animal and Clinical Studies. Viruses Liu, D., Van Belleghem, J. D., de Vries, C. R., Burgener, E., Chen, Q., Manasherob, R., Aronson, J. R., Amanatullah, D. F., Tamma, P. D., Suh, G. A. 2021; 13 (7)

  Abstract

  Increasing rates of infection by antibiotic resistant bacteria have led to a resurgence of interest in bacteriophage (phage) therapy. Several phage therapy studies in animals and humans have been completed over the last two decades. We conducted a systematic review of safety and toxicity data associated with phage therapy in both animals and humans reported in English language publications from 2008-2021. Overall, 69 publications met our eligibility criteria including 20 animal studies, 35 clinical case reports or case series, and 14 clinical trials. After summarizing safety and toxicity data from these publications, we discuss potential approaches to optimize safety and toxicity monitoring with the therapeutic use of phage moving forward. In our systematic review of the literature, we found some adverse events associated with phage therapy, but serious events were extremely rare. Comprehensive and standardized reporting of potential toxicities associated with phage therapy has generally been lacking in the published literature. Structured safety and tolerability endpoints are necessary when phages are administered as anti-infective therapeutics.

  View details for DOI 10.3390/v13071268

  View details for PubMedID 34209836

• Incidence of Active Tuberculosis Following Hematopoietic Cell Transplantation: A Small but Real Threat. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Aronson, J. R., Rezvani, A. R., Subramanian, A. n. 2019

  View details for DOI 10.1093/cid/ciz592

  View details for PubMedID 31297538