Heime Rieber1, Andre Frontzek2, Stephanie Heinrich3, Andreas Breil-Wirth4, Julian Messler5, Stefan Hegermann6, Martin Ulatowski7, Christos Koutras8, Enno Steinheisser9, Thomas Kruppa10, Martin Fischer11, Michael Hammer12, Arjan Mullahi13, Thomas Morawietz14. 1. MVZ Dr Stein and Colleagues, Division of Microbiology, Mönchengladbach, Germany. Electronic address: hrieber@labor-stein.de. 2. MVZ Dr Stein and Colleagues, Division of Microbiology, Mönchengladbach, Germany. 3. Krankenhaus Düren, Klinik für Unfall- und Orthopädische Chirurgie, Düren, Germany. 4. Johanna-Etienne-Krankenhaus, Klinik für Orthopädie, Unfallchirurgie und Sportmedizin, Neuss, Germany. 5. Kliniken Maria Hilf, Klinik für Orthopädie und Unfallchirurgie, Mönchengladbach, Germany. 6. Städtische Kliniken, Klinik für Unfall- und Gelenkchirurgie, Mönchengladbach, Germany. 7. Sana Krankenhaus, Abteilung für Orthopädie und Unfallchirurgie, Radevormwald, Germany. 8. Krankenhaus Neuwerk, Klinik für Orthopädie, Unfallchirurgie und Wirbelsäulentherapie, Mönchengladbach, Germany. 9. Städtisches Krankenhaus, Klinik für Orthopädie und Unfallchirurgie, Nettetal, Germany. 10. St. Augustinus Krankenhaus, Klinik für Orthopädie und Unfallchirurgie, Düren, Germany. 11. Johanniter Hospital, Department of Orthopaedics, General and Accident Surgery, Duisburg, Germany. 12. Schön Klinik, Fachzentrum für Endoprothetik, Düsseldorf, Germany. 13. St. Josef-Krankenhaus, Abteilung für Orthopädie und Unfallchirurgie, Linnich, Germany. 14. Agaplesion Bethesda Krankenhaus, Klinik für Unfallchirurgie und Orthopädische Chirurgie, Wuppertal, Germany.
Abstract
OBJECTIVES: In the microbiological diagnosis of periprosthetic joint infection (PJI), there is much discussion about the methodology of obtaining proper specimens, the processing technique, and suitable culture media. This retrospective study was conducted to analyse the accuracy of our culture techniques. METHODS: Tissue samples and components from 258 patients after revision arthroplasty of the hip, knee, and shoulder were investigated, and the results of tissue cultures (TC) were compared to those of sonicate fluid cultures (SFC). Furthermore, an evaluation was performed of the influence of different culture media on the detection rate. RESULTS: PJI was confirmed in 186 patients. The overall sensitivity of TC was no different to that of SFC (91.3% vs 90.8%, P = 1). In 153 cases (82.3%), TC and SFC showed concordant positive results. Results were discordant in 33 cases (17.7%). When differentiated according to the type of infection, TC showed significantly better results than SFC in detecting polymicrobial infections (97.0% vs 67.0%, P = 0.004). There were also significant differences between the culture media regarding the yield of microorganisms. CONCLUSIONS: TC was more effective in detecting co-infections. The best results were obtained using both TC and SFC. The choice of culture media has a significant influence on the quality of results.
OBJECTIVES: In the microbiological diagnosis of periprosthetic joint infection (PJI), there is much discussion about the methodology of obtaining proper specimens, the processing technique, and suitable culture media. This retrospective study was conducted to analyse the accuracy of our culture techniques. METHODS: Tissue samples and components from 258 patients after revision arthroplasty of the hip, knee, and shoulder were investigated, and the results of tissue cultures (TC) were compared to those of sonicate fluid cultures (SFC). Furthermore, an evaluation was performed of the influence of different culture media on the detection rate. RESULTS: PJI was confirmed in 186 patients. The overall sensitivity of TC was no different to that of SFC (91.3% vs 90.8%, P = 1). In 153 cases (82.3%), TC and SFC showed concordant positive results. Results were discordant in 33 cases (17.7%). When differentiated according to the type of infection, TC showed significantly better results than SFC in detecting polymicrobial infections (97.0% vs 67.0%, P = 0.004). There were also significant differences between the culture media regarding the yield of microorganisms. CONCLUSIONS:TC was more effective in detecting co-infections. The best results were obtained using both TC and SFC. The choice of culture media has a significant influence on the quality of results.
Authors: Alessandra Oliva; Maria Claudia Miele; Dania Al Ismail; Federica Di Timoteo; Massimiliano De Angelis; Luigi Rosa; Antimo Cutone; Mario Venditti; Maria Teresa Mascellino; Piera Valenti; Claudio Maria Mastroianni Journal: Front Microbiol Date: 2021-10-29 Impact factor: 5.640