Differences in Diagnostic Properties Between Standard and Enrichment Culture Techniques Used in Periprosthetic Joint Infections

Watanabe, S.; Kobayashi, Naomi; Tomoyama, Akito; Choe, Han-Cheol; Yamazaki, Etsuko; Inaba, Yutaka

doi:10.1016/j.arth.2019.08.035

Cited by 6 publications

(6 citation statements)

References 33 publications

(25 reference statements)

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“…The enrichment culture was performed for 5 days at 35 °C in ambient air composition. When a sample was negative in the enrichment culture, it was culture-negative 43 . Bacteria were identified through analysis of biological properties using MicroScan WalkAway system with combo panels (Beckman Coulter, Brea, CA).…”

Section: Methodsmentioning

confidence: 99%

Inflammation and nutrition based screening tests for detection of infection in cases of rapid hip destruction

Abe

Choe

Oba

et al. 2022

Sci Rep

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Preoperative diagnosis of infection is important for appropriate surgical treatment of patients with rapid hip destruction (RHD). We investigated whether test results, including inflammatory and nutritional markers, could be used to accurately differentiate infectious and non-infectious RHD. Fifty patients with RHD who underwent total hip arthroplasty within a year of onset were observed. Infectious RHD was defined as ≥ 2 positive serological inflammatory, microbiological, or pathological evaluations. The albumin to globulin ratio (AGR), C-reactive protein (CRP)/albumin ratio (CAR), Glasgow prognostic score (GPS), modified GPS (mGPS), prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and platelet to lymphocyte ratio (PLR) were calculated from the blood test results. In the infectious group, the white blood cell count, platelet count, CRP level, erythrocyte sedimentation rate, CAR, GPS, mGPS, and PLR were significantly higher, while the albumin level, AGR, PNI, and GNRI were significantly lower. The CRP and albumin levels showed the highest sensitivity (1.00 for both; specificity of 0.87 and 0.73, respectively) in diagnosing infectious RHD. Combining these measurements (CAR) increased the specificity to 0.92. The accuracy of other nutritional assessments was good. Thus, nutritional assessment as well as conventional assessment of the inflammatory response can improve the accuracy of preoperative diagnosis of infectious RHD.

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Section: Methodsmentioning

confidence: 99%

Inflammation and nutrition based screening tests for detection of infection in cases of rapid hip destruction

Abe

Choe

Oba

et al. 2022

Sci Rep

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“…Standard culture was performed at first. If samples were not cultured using standard culture methods, an enrichment culture method was performed using broth culture medium for 5 days according to a previous study [ 18 ]. Briefly, standard culture was performed using 5% sheep’s blood agar plates containing peptone and sodium chloride.…”

Section: Methodsmentioning

confidence: 99%

Clinical characteristics and risk factors for culture-negative periprosthetic joint infections

et al. 2021

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Background Culture-negative periprosthetic joint infections (PJIs) can complicate diagnosis and management of PJI. This study aimed to identify risk factors for culture-negative PJI and differences in clinical characteristics between culture-positive and culture-negative PJI group. Methods This retrospective, cross-sectional study evaluated PJI cases obtained between January 2013 and October 2019 at our institution. These PJI cases were divided into culture-positive and culture-negative groups and then compared. The demographics, laboratory findings, and details of patient’s clinical characteristics were investigated. Univariate and multivariate logistic regression analysis were performed to investigate risk factors for culture-negative PJI. Results A total of 109 PJI cases were included in the analysis: 82 (75%) culture-positive and 27 (25%) culture-negative. The mean serum white blood cell (WBC) count, C-reactive protein level, and erythrocyte sedimentation rate in the culture-negative group were significantly lower than those in the culture-positive group (p < 0.05). There were no significant differences between the two groups regarding history of prior antibacterial administration or treatment success rates. Multivariate analysis identified a low serum WBC count as a risk factor for culture-negative PJI (odds ratio = 0.78; 95% confidence interval [CI] = 0.63–0.97; p = 0.027). Conclusions A low serum WBC count is a risk factor for culture-negative PJI, but prior antimicrobial therapy is not. The results suggest that PJI cases with lower levels of systemic inflammation are likely to be culture-negative; therefore, the possibility of a culture-negative result should be considered in suspected cases of PJI with low inflammatory markers, regardless of prior antibiotic exposure.

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“…Standard culture was performed at rst. If samples were not cultured using standard culture methods, an enrichment culture method was performed using broth culture medium for 5 days according to a previous study [15]. Brie y, standard culture was performed using 5% sheep's blood agar plates containing peptone and sodium chloride.…”

Section: Culture Methodsmentioning

confidence: 99%

Clinical Characteristics and Risk Factors for Culture-Negative Periprosthetic Joint Infections

Watanabe

Kobayashi

Tomoyama

et al. 2021

Preprint

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Background Culture-negative periprosthetic joint infections (PJIs) can complicate diagnosis and management of PJI. This study aimed to identify risk factors for culture-negative PJI and differences in clinical characteristics between culture-positive and culture-negative PJI group. Methods This retrospective, cross-sectional study evaluated PJI cases obtained between January 2013 and October 2019 at our institution. These PJI cases were divided into culture-positive and culture-negative groups and then compared. The demographics, laboratory findings, and details of patient’s clinical characteristics were investigated. Univariate and multivariate logistic regression analysis were performed to investigate risk factors for culture-negative PJI. Results A total of 109 PJI cases were included in the analysis: 82 (75%) culture-positive and 27 (25%) culture-negative. The mean serum white blood cell (WBC) count, C-reactive protein level, erythrocyte sedimentation rate in the culture-negative group were significantly lower than those in the culture-positive group (p < 0.05). There were no significant differences between the two groups regarding history of prior antibacterial administration or treatment success rates. Multivariate analysis identified a low serum WBC count as a risk factor for culture-negative PJI (odds ratio = 0.78; 95% confidence interval [CI] = 0.63–0.97; p = 0.027). Conclusions A low serum WBC count is a risk factor for culture-negative PJI, but prior antimicrobial therapy is not. The results suggest that PJI cases with lower levels of systemic inflammation are likely to be culture-negative; therefore, the possibility of a culture-negative result should be considered in suspected cases of PJI with low inflammatory markers, regardless of prior antibiotic exposure.

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Differences in Diagnostic Properties Between Standard and Enrichment Culture Techniques Used in Periprosthetic Joint Infections

Cited by 6 publications

References 33 publications

Inflammation and nutrition based screening tests for detection of infection in cases of rapid hip destruction

Inflammation and nutrition based screening tests for detection of infection in cases of rapid hip destruction

Clinical characteristics and risk factors for culture-negative periprosthetic joint infections

Clinical Characteristics and Risk Factors for Culture-Negative Periprosthetic Joint Infections

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