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The Oxford Bone Infection Unit

The Bone Infection Unit at the Nuffield Orthopaedic Centre is part of the Oxford University Hospitals (OUH) NHS Trust. It remains dedicated to the investigation and treatment of all aspects of bone and joint infection, including chronic long-bone osteomyelitis, diabetic foot infections, spinal osteomyelitis and orthopaedic device-related infection. In addition to local GP referrals, it is a tertiary referral centre for patients across the UK, many referrals being complex infected cases from other orthopaedic surgeons. The centre of activity of the unit is a 26-bed dedicated inpatient ward. Each patient is under the combined care of a consultant infection physician and a specialist orthopaedic surgeon (together with trainees in both specialities).

Many cases also have a plastic surgeon involved. There is a full multi-disciplinary team and a large outpatient parenteral antibiotic therapy (OPAT) programme. The BIU runs consultant ward-rounds, ward multidisciplinary team (MDT) meetings, radiology MDT meetings, a weekly combined orthopaedic / infection / plastics new and follow up outpatient clinic and also an OPAT clinic. There is an active education programme. The BIU is an ESCMID collaborative centre and accommodates observers via that route and also by direct communication. There is also a research group with many publications and on-going projects, including leading the multicentre OVIVA (oral vs. IV antibiotic trial).

There is close liaison with the infection control team throughout the NOC. The unit is also closely integrated with the OUH departments of adult and paediatric infectious diseases and microbiology. The BIU is a major contributor to the UK Standards for Microbiological Investigations (specimens from prosthetic joint infections and osteomyelitis).