Culturing periprosthetic tissue in BacT/Alert® Virtuo blood culture system leads to improved and faster detection of prosthetic joint infections

Abstract

Background Blood culture bottles (BCBs) provide a semiautomated method for culturing periprosthetic tissue specimens. A study evaluating BCBs for culturing clinical samples other than body fluids is needed before implementation into clinical practice. Our objective was to evaluate use of the BacT/Alert® Virtuo blood culture system for culturing periprosthetic tissue specimens. Methods The study was performed through the analysis of spiked ( n = 36) and clinical ( n = 158) periprosthetic tissue samples. Clinical samples were analyzed by the BCB method and the results were compared to the conventional microbiological culture-based method for time to detection and microorganisms identified. Results The BacT/Alert® Virtuo blood culture system detected relevant bacteria for prosthetic joint infection in both spiked and clinical samples. The BCB method was found to be as sensitive (79%) as the conventional method (76%) ( p = 0.844) during the analyses of clinical samples. The BCB method yielded positive results much faster than the conventional method: 89% against 27% detection within 24 h, respectively. The median detection time was 11.1 h for the BCB method (12 h and 11 h for the aerobic and the anaerobic BCBs, correspondingly). Conclusion We recommend using the BacT/Alert® Virtuo blood culture system for analyzing prosthetic joint tissue, since this detect efficiently and more rapidly a wider range of bacteria than the conventional microbiological method. Electronic supplementary material The online version of this article (10.1186/s12879-019-4206-x) contains supplementary material, which is available to authorized users.

Culturing Periprosthetic Tissues in BacT/Alert® Virtuo Blood Culture Bottles for a Short Duration of Post-operative Empirical Antibiotic Therapy

“…Moreover, it showed higher sensitivity than conventional culture methods in cases with previous antibiotic treatment since bottles contain antimicrobial removal systems [15,16]. Another advantage is a shorter time for microorganism detection compared to conventional culture methods [12,15]. In our study, all strains except C. acnes, one strain of C. avidum and one strain of S. gordonii grew within the first five days, accounting for 94.6% of positive surgical procedures.…”

“…Several studies pointed out an improvement of sensitivity of detection of organisms causing PJI compared to conventional culture methods [8,9,10,11]. Recently, Sanabria et al studied BacT/Alert® Virtuo blood culture bottle system and showed it was as slightly more sensitive than conventional methods [12]. Other advantages include a reduced number of specimen required (3 for the most accurate diagnosis in a study performed in 2016) [13], a potential personnel time and labor cost savings [14], and a lower risk of contamination linked to daily inspection of plates.…”

Meta-analysis in periprosthetic joint infection: a global bibliometric analysis

“…Yet, the drawback of sonicate fluid BCB was the rate of false-positives, which was caused by contamination during the inoculation procedure of BCB with sonicate fluid. Therefore, careful handling is required to minimize contamination [30,31]. Tissue and tissue swab GS were the two least frequently applied intraoperative tests, with a sensitivity of less than 20%.…”

Shotgun-Metagenomics on Positive Blood Culture Bottles Inoculated With Prosthetic Joint Tissue: A Proof of Concept Study

“…In brief, three different types of BCB samples were obtained during that study: BCBs inoculated with PJT clinical samples from patients with suspicion of PJI, BCBs inoculated with tissue spiked with bacterial species reported as common microbiological causes of PJI and a negative control which was prepared by inoculating sterilized tissue (irradiated to 25 Gy) from a crushed native femoral head. For further details on the BCB sample preparation method, see Sanabria et al (2019).…”

“…Nine of the PJT clinical samples in this study had previously been analyzed using a conventional and a BCB method (Sanabria et al, 2019). Bacterial identification for both methods was done using MALDI-TOF.…”