Árpád Dandé1, László G Nöt2, Gábor Bűcs1, Béla Kocsis3, Dénes Lőrinczy4, Norbert Wiegand1. 1. Department of Traumatology and Hand Surgery, Clinical Centre, Faculty of Medicine, University of Pécs, Ifjúság u 13, JPKT Building, 7th floor, Pécs, H-7624, Hungary. 2. Department of Traumatology and Hand Surgery, Clinical Centre, Faculty of Medicine, University of Pécs, Ifjúság u 13, JPKT Building, 7th floor, Pécs, H-7624, Hungary. Electronic address: laszlogn@icloud.com. 3. Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Pécs, Szigeti út 12, Pécs, H-7624, Hungary. 4. Department of Biophysics, Faculty of Medicine, University of Pécs, Szigeti út 12, Pécs, H-7624, Hungary.
Abstract
OBJECTIVES: To evaluate the efficacy of conventional microbiological examinations in the diagnostics of septic joint and periprosthetic inflammations. DESIGN AND SETTING: Evidence Level IV, retrospective clinical study of case series. Patients treated with small and large joint septic inflammations or with periprosthetic joint infections (PJI) were entered into the study. Demographics, microbiological cultures and inflammatory mediators were evaluated. PARTICIPANTS: Between 2012 and 2016, total of 1116 hip and 241 knee surgeries were performed at our Department in relation to prostheses; including primary and revision arthroplasties and further surgeries due to PJI. During this period, 72 patients were operated with large joints infections or PJI and another 65 patients were treated due to small joint infections. MAIN OUTCOME MEASURES: The main outcome of interest was to evaluate the sensitivity of conventional microbiological cultures in the primary diagnostics of joint and periprosthetic infections. RESULTS: The most frequent bacteria strains were the Staphylococci: in 43 cases (22.16%) Staphylococcus aureus, in 22 cases (11.34%) coagulase-negative Staphylococcus, in 3 cases (1.54%) Staphylococcus epidermidis and in 4 cases (2.06%) methicillin-resistant S. aureus (MRSA) were detected. In 30 cases (21.88%), the primary microbiological investigation could not reveal the presence of bacteria. CONCLUSION: Based on our data, the efficacy of conventional microbiological testing in the diagnostics of different type of joint infections is questionable. Therefore, further studies are warranted to evaluate the efficacy of novel diagnostic testing tools in prospective randomized controlled trials.
OBJECTIVES: To evaluate the efficacy of conventional microbiological examinations in the diagnostics of septic joint and periprosthetic inflammations. DESIGN AND SETTING: Evidence Level IV, retrospective clinical study of case series. Patients treated with small and large joint septic inflammations or with periprosthetic joint infections (PJI) were entered into the study. Demographics, microbiological cultures and inflammatory mediators were evaluated. PARTICIPANTS: Between 2012 and 2016, total of 1116 hip and 241 knee surgeries were performed at our Department in relation to prostheses; including primary and revision arthroplasties and further surgeries due to PJI. During this period, 72 patients were operated with large joints infections or PJI and another 65 patients were treated due to small joint infections. MAIN OUTCOME MEASURES: The main outcome of interest was to evaluate the sensitivity of conventional microbiological cultures in the primary diagnostics of joint and periprosthetic infections. RESULTS: The most frequent bacteria strains were the Staphylococci: in 43 cases (22.16%) Staphylococcus aureus, in 22 cases (11.34%) coagulase-negative Staphylococcus, in 3 cases (1.54%) Staphylococcus epidermidis and in 4 cases (2.06%) methicillin-resistant S. aureus (MRSA) were detected. In 30 cases (21.88%), the primary microbiological investigation could not reveal the presence of bacteria. CONCLUSION: Based on our data, the efficacy of conventional microbiological testing in the diagnostics of different type of joint infections is questionable. Therefore, further studies are warranted to evaluate the efficacy of novel diagnostic testing tools in prospective randomized controlled trials.