Comparison of bacterial culture results of preoperative synovial fluid and intraoperative specimens in patients with joint infection

Imagama, Takashi; Nakashima, Daisuke; Seki, Kazushige; Seki, Toshihiro; Matsuki, Yuta; Yamazaki, Kazuhiro; Sakai, Takashi

doi:10.1016/j.jiac.2020.11.006

Cited by 5 publications

(7 citation statements)

References 20 publications

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“…Pathogen identification is pivotal in the management of PJI since the information on PJI pathogens can guide perioperative antibiotics administration, treatment protocols and predict prognosis [ 3 ]. Although preoperative aspiration cultures are more convenient than intraoperative cultures, these culture results were obtained preoperatively, raising the possibility of suboptimal treatment protocol if discordant cultures were encountered [ 4 , 5 , 11 ]. Up to now, only one study investigated the concordance between preoperative aspiration and intraoperative SF culture, but these efforts were restricted to the limited number of PJI and septic arthritis patients [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge, some studies revealed the difference between preoperative aspiration cultures and intraoperative tissue cultures but no studies comprehensively evaluated the concordance between preoperative aspiration culture and intraoperative synovial fluid culture [ 5 ]. Based on the EBJIS criteria of periprosthetic joint infection, both synovial fluid and at least five reliable tissue samples must be obtained using separate instruments and immediately transferred to the laboratory for culture.…”

Section: Introductionmentioning

confidence: 99%

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The concordance between preoperative aspiration and intraoperative synovial fluid culture results: intraoperative synovial fluid re-cultures are necessary whether the preoperative aspiration culture is positive or not

Hao

et al. 2021

BMC Infect Dis

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Aims Preoperative aspiration culture and intraoperative cultures play pivotal roles in periprosthetic joint infection (PJI) diagnosis and pathogen identification. But the discordance between preoperative aspiration culture and intraoperative synovial fluid culture remains unknown. We aim to determine (1) the discordance between preoperative and intraoperative synovial fluid (SF) culture and. (2) compared to intraoperative synovial fluid cultures, the sensitivity of preoperative aspiration fluid culture. Then the following question is tried to be answered: Are intraoperative synovial fluid re-cultures necessary if the preoperative aspiration culture is positive? Materials and methods Between 2015 and 2019, 187 PJI patients managed with surgeries were included in this study. Compared to intraoperative synovial fluid culture, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of preoperative aspiration culture were calculated. Then, the discordance between preoperative aspiration culture and intraoperative SF culture was analyzed. Results The sensitivity of preoperative aspiration culture was 81.29% compared to intraoperative synovial fluid cultures. Concordance was identified in 147 PJI (78.61%) patients and culture discordance occurred in 40 patients (21.39%). In these discordant PJI patients, 24 patients (60%) were polymicrobial and no intraoperative synovial fluid culture growth was found in 16 PJI cases (40%). Preoperative monomicrobial staphylococcus results had a sensitivity of and a specificity of 80.43% and 83.16%, respectively. Preoperative polymicrobial results had the lowest sensitivity. Conclusions The intraoperative synovial fluid re-cultures are necessary if the preoperative aspiration culture is positive and the discordance between preoperative aspiration culture and intraoperative synovial fluid culture should be noted especially when Streptococcus spp. and more than one pathogen was revealed by preoperative aspiration culture. Level of evidence: Level III.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The concordance between preoperative aspiration and intraoperative synovial fluid culture results: intraoperative synovial fluid re-cultures are necessary whether the preoperative aspiration culture is positive or not

Hao

et al. 2021

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…Pathogen identi cation is pivotal in the management of PJI since the information on PJI pathogens can guide perioperative antibiotics administration, treatment protocols and predict prognosis [1]. Although preoperative aspiration cultures are more convenient than intraoperative cultures, these culture results were obtained preoperatively, raising the possibility of suboptimal treatment protocol if discordant cultures were encountered [2,3,8]. Up to now, only one study investigated the concordance between preoperative aspiration and intraoperative SF culture, but these efforts were restricted to the limited number of PJI and septic arthritis patients [3].…”

Section: Discussionmentioning

confidence: 99%

“…Although preoperative aspiration cultures are more convenient than intraoperative cultures, these culture results were obtained preoperatively, raising the possibility of suboptimal treatment protocol if discordant cultures were encountered [2,3,8]. Up to now, only one study investigated the concordance between preoperative aspiration and intraoperative SF culture, but these efforts were restricted to the limited number of PJI and septic arthritis patients [3]. We studied a large PJI cohort to comprehensively evaluate the difference between preoperative aspiration cultures and intraoperative synovial uid cultures.…”

Section: Discussionmentioning

confidence: 99%

“…Identifying the offending pathogens in PJI patients is critical in initiating early antibiotic administration, choosing optimal surgical management strategy, and predicting prognosis. Preoperative joint aspiration is pivotal in the management of PJI patients because the preoperative identi cation of PJI pathogens and subsequent antibiotics sensitivity test (AST) can guide perioperative antibiotics administration and the selection of optimal surgery method [2] However, to our knowledge, some studies revealed the difference between preoperative aspiration cultures and intraoperative tissue cultures but no studies comprehensively evaluated the concordance between preoperative aspiration culture and intraoperative synovial uid culture [3]. Based on the EBJIS criteria of periprosthetic joint infection, both synovial uid and at least ve reliable tissue samples must be obtained using separate instruments and immediately transferred to the laboratory for culture.…”

Section: Introductionmentioning

confidence: 99%

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The Concordance between Preoperative Aspiration and Intraoperative Synovial Fluid Culture Results: Intraoperative Synovial Fluid Re-Cultures Are Necessary whether the Preoperative Aspiration Culture is Positive or Not.

Hao

et al. 2021

Preprint

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Aims: Preoperative aspiration culture and intraoperative cultures play pivotal roles in periprosthetic joint infection (PJI) diagnosis and pathogen identification. But the discordance between preoperative aspiration culture and intraoperative synovial fluid culture remains unknown. We aim to determine 1）the discordance between preoperative and intraoperative synovial fluid (SF) culture and. 2) compared to intraoperative synovial fluid cultures, the sensitivity of preoperative aspiration fluid culture. Then the following question is tried to be answered: Are intraoperative synovial fluid re-cultures necessary if the preoperative aspiration culture is positive?Materials and methods:Between 2015 and 2019, 187 PJI patients managed with surgeries were included in this study. Compared to intraoperative synovial fluid culture, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of preoperative aspiration culture were calculated. Then, the discordance between preoperative aspiration culture and intraoperative SF culture was analyzed. Results:The sensitivity of preoperative aspiration culture was 81.29% compared to intraoperative synovial fluid cultures. Concordance was identified in 147 PJI (78.61%) patients and culture discordance occurred in 40 patients (21.39%). In these discordant PJI patients, 24 patients (60%) were polymicrobial and no intraoperative synovial fluid culture growth was found in 16 PJI cases (40%). Preoperative monomicrobial staphylococcus results had a sensitivity of and a specificity of 80.43% and 83.16%, respectively. Preoperative polymicrobial results had the lowest sensitivity.Conclusions: The intraoperative synovial fluid re-cultures are necessary if the preoperative aspiration culture is positive and the discordance between preoperative aspiration culture and intraoperative synovial fluid culture should be noted especially when streptococcus spp. and more than one pathogen was revealed by preoperative aspiration culture.

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Differences in Diagnostic Sensitivity of Cultures Between Sample Types in Periprosthetic Joint Infections: A Systematic Review and Meta-Analysis

Watanabe,

Kamono,

Choe

et al. 2024

The Journal of Arthroplasty

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Comparison of bacterial culture results of preoperative synovial fluid and intraoperative specimens in patients with joint infection

Cited by 5 publications

References 20 publications

The concordance between preoperative aspiration and intraoperative synovial fluid culture results: intraoperative synovial fluid re-cultures are necessary whether the preoperative aspiration culture is positive or not

The concordance between preoperative aspiration and intraoperative synovial fluid culture results: intraoperative synovial fluid re-cultures are necessary whether the preoperative aspiration culture is positive or not

The Concordance between Preoperative Aspiration and Intraoperative Synovial Fluid Culture Results: Intraoperative Synovial Fluid Re-Cultures Are Necessary whether the Preoperative Aspiration Culture is Positive or Not.

Differences in Diagnostic Sensitivity of Cultures Between Sample Types in Periprosthetic Joint Infections: A Systematic Review and Meta-Analysis

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