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Effects of different tissue specimen pretreatment methods on microbial culture results in the diagnosis of periprosthetic joint infection
- Source :
- Bone & Joint Research, Vol 10, Iss 2, Pp 96-104 (2021), Bone & Joint Research
- Publication Year :
- 2021
- Publisher :
- British Editorial Society of Bone & Joint Surgery, 2021.
-
Abstract
- Aims Microbiological culture is a key element in the diagnosis of periprosthetic joint infection (PJI). However, cultures of periprosthetic tissue do not have optimal sensitivity. One of the main reasons for this is that microorganisms are not released from the tissues, either due to biofilm formation or intracellular persistence. This study aimed to optimize tissue pretreatment methods in order to improve detection of microorganisms. Methods From December 2017 to September 2019, patients undergoing revision arthroplasty in a single centre due to PJI and aseptic failure (AF) were included, with demographic data and laboratory test results recorded prospectively. Periprosthetic tissue samples were collected intraoperatively and assigned to tissue-mechanical homogenization (T-MH), tissue-manual milling (T-MM), tissue-dithiothreitol (T-DTT) treatment, tissue-sonication (T-S), and tissue-direct culture (T-D). The yield of the microbial cultures was then analyzed. Results A total of 46 patients were enrolled, including 28 patients in the PJI group and 18 patients in the AF group. In the PJI group, 23 cases had positive culture results via T-MH, 22 cases via T-DTT, 20 cases via T-S, 15 cases via T-MM, and 13 cases via T-D. Three cases under ongoing antibiotic treatment remained culture-negative. Five tissue samples provided the optimal yield. Any ongoing antibiotic treatment had a relevant influence on culture sensitivity, except for T-DTT. Conclusion T-MH had the highest sensitivity. Combining T-MH with T-DTT, which requires no special equipment, may effectively improve bacterial detection in PJI. A total of five periprosthetic tissue biopsies should be sampled in revision arthroplasty for optimal detection of PJI. Cite this article: Bone Joint Res 2021;10(2):96–104.
- Subjects :
- 030222 orthopedics
0303 health sciences
Pathology
medicine.medical_specialty
periprosthetic joint infection
lcsh:Diseases of the musculoskeletal system
Microbiological culture
030306 microbiology
business.industry
Periprosthetic
pretreatment
Pretreatment method
culture
03 medical and health sciences
0302 clinical medicine
Tissue specimen
Medicine
Orthopedics and Sports Medicine
Surgery
lcsh:RC925-935
Infection
business
Subjects
Details
- ISSN :
- 20463758
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Bone & Joint Research
- Accession number :
- edsair.doi.dedup.....ab9c7f7ef495c17bd4175f4c413629aa