2018
DOI: 10.12659/msm.908585
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Does Use of Lidocaine Affect Culture of Synovial Fluid Obtained to Diagnose Periprosthetic Joint Infection (PJI)? An In Vitro Study

Abstract: BackgroundSynovial fluid culture (SFC) is recommended as one of the major diagnostic criteria by the Musculoskeletal Infection Society (MSIS) for diagnosing periprosthetic joint infection (PJI). Local anesthetic agents are used for anesthesia and analgesia in some clinical settings to relieve pain. As a local anesthetic, lidocaine is safely used in arthrocentesis to obtain synovial fluid. The goal of this study was to determine if infiltration anesthesia with additive-free lidocaine 2% has antibacterial effect… Show more

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Cited by 10 publications
(8 citation statements)
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“…To preliminarily examine the concept that methylene blue (MB) can produce false-negative results of bacterial culture, an in vitro experiment was performed to test the antibacterial properties of MB on common PJI pathogenic bacteria, which was the same as the previous publication of our study [ 12 ]. The bacteria used in this study were 8 isolates of reference strains of Staphylococcus aureus (SAU) (ATCC 25923), Staphylococcus epidermidis (SEP) (ATCC 14990), Staphylococcus hominis (SHO) (ATCC 27844), Escherichia coli (ECO) (ATCC 11775), Klebsiella pneumoniae (KPN) (ATCC 13883), Acinetobacter baumannii (ABA) (ATCC 19606), Streptococcus pyogenes (SPY) (ATCC 12344), and Candida albicans (CAL) (ATCC 90028), all originally from the American Type Culture Collection, Manassas, VA).…”
Section: Methodsmentioning
confidence: 99%
See 1 more Smart Citation
“…To preliminarily examine the concept that methylene blue (MB) can produce false-negative results of bacterial culture, an in vitro experiment was performed to test the antibacterial properties of MB on common PJI pathogenic bacteria, which was the same as the previous publication of our study [ 12 ]. The bacteria used in this study were 8 isolates of reference strains of Staphylococcus aureus (SAU) (ATCC 25923), Staphylococcus epidermidis (SEP) (ATCC 14990), Staphylococcus hominis (SHO) (ATCC 27844), Escherichia coli (ECO) (ATCC 11775), Klebsiella pneumoniae (KPN) (ATCC 13883), Acinetobacter baumannii (ABA) (ATCC 19606), Streptococcus pyogenes (SPY) (ATCC 12344), and Candida albicans (CAL) (ATCC 90028), all originally from the American Type Culture Collection, Manassas, VA).…”
Section: Methodsmentioning
confidence: 99%
“…According to the results of recent studies, several disclosing agents with various contents may have a role in quickly detecting biofilms on orthopedic prostheses [9][10][11][12]. To be used effectively in an operative setting, a disclosing agent would need to stain biofilm on the implant or tissue and have limited antimicrobial activity, so the organism could be grown in culture.…”
Section: Introductionmentioning
confidence: 99%
“…Outra situação em que o anestésico local pode ter ação negativa, é em culturas do líquido sinovial. Em seu experimento in vitro, Liu et al (2018) definiram que a infiltração de Lidocaína a 2% teve efeito antibacteriano em 8 isolados, sendo estes: Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Streptococcus pyogenes e Candida albicans. Segundo os autores, a densidade bacteriana incubada neste estudo foi supra-fisiológica e a Lidocaína afetou de forma rápida e significativa a viabilidade microbiana de todas as cepas, exceto do Streptococcus pyogenes, sendo que Staphylococcus aureus, Staphylococcus epidermidis, Acinetobacter baumannii e Klebsiella pneumoniae foram os microrganismos mais susceptíveis.…”
Section: Ação Antimicrobiana Localunclassified
“…Com base nisto, é possível perceber que esse anestésico local, em concentrações próximas à utilizada em seu uso clínico, pode interferir negativamente na cultura do líquido sinovial, quando administrado na forma de injeção infiltrativa antes da coleta, o que poderia resultar em resultados falsonegativos. Apesar disso, um efeito benéfico também pode ser possível, caso a Lidocaína a 2% possa agir reduzindo a ocorrência de artrites sépticas de ocorrência iatrogênica (LIU et al, 2018).…”
Section: Ação Antimicrobiana Localunclassified
“…Single stage revision should not be performed without this information as antibiotic treatment cannot be tailored to combat the infection. Aspiration of the joint is performed with the patient off antibiotics for at least 14 d, using an “as sterile as possible technique” and with a culture incubation period of 14 d. Studies have suggested anesthetics such as lidocaine and ethyl chloride spray can affect bacterial growth[ 18 , 19 ]. Because of this, our institution does not use local anesthetic while aspirating the joint.…”
Section: Key Principles Of Single Stagementioning
confidence: 99%