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Poor performance of microbiological sampling in the prediction of recurrent arthroplasty infection

Authors :
Schindler, Maximilian
Christofilopoulos, Panayiotis
Wyssa, Blaise
Belaieff, Wilson
Garzoni, Christian
Bernard, Louis
Lew, Daniel
Hoffmeyer, Pierre
Uçkay, Ilker
Schindler, Maximilian
Christofilopoulos, Panayiotis
Wyssa, Blaise
Belaieff, Wilson
Garzoni, Christian
Bernard, Louis
Lew, Daniel
Hoffmeyer, Pierre
Uçkay, Ilker

Abstract

During a two-stage revision for prosthetic joint infections (PJI), joint aspirations, open tissue sampling and serum inflammatory markers are performed before re-implantation to exclude ongoing silent infection. We investigated the performance of these diagnostic procedures on the risk of recurrence of PJI among asymptomatic patients undergoing a two-stage revision. A total of 62 PJI were found in 58 patients. All patients had intra-operative surgical exploration during re-implantation, and 48 of them had intra-operative microbiological swabs. Additionally, 18 joint aspirations and one open biopsy were performed before second-stage reimplantation. Recurrence or persistence of PJI occurred in 12 cases with a mean delay of 218days after re-implantation, but only four pre- or intraoperative invasive joint samples had grown a pathogen in cultures. In at least seven recurrent PJIs (58%), patients had a normal C-reactive protein (CRP, <10mg/l) level before re-implantation. The sensitivity, specificity, positive predictive and negative predictive values of pre-operative invasive joint aspiration and CRP for the prediction of PJI recurrence was 0.58, 0.88, 0.5, 0.84 and 0.17, 0.81, 0.13, 0.86, respectively. As a conclusion, pre-operative joint aspiration, intraoperative bacterial sampling, surgical exploration and serum inflammatory markers are poor predictors of PJI recurrence. The onset of reinfection usually occurs far later than reimplantation

Details

Database :
OAIster
Notes :
English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1043535844
Document Type :
Electronic Resource