Periprosthetic joint infection caused by anaerobes. Retrospective analysis reveals no need for prolonged cultivation time if sensitive supplemented growth media are used

Rieber, Heime; Frontzek, André; Jerosch, Jörg; Alefeld, Michael; Strohecker, Thomas; Ulatowski, M; Morawietz, Thomas; Hinsenkamp, Stefan; Bell, Andreas; Kücükköylü, Dervis; Frommelt, Lars

doi:10.1016/j.anaerobe.2018.01.009

Cited by 22 publications

(16 citation statements)

References 17 publications

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“…Waites et al demonstrated that the ingredients of commercial blood culture media are not suitable for multiplying M. hominis, confirming our negative results from incubated joint fluid (Waites and Canupp, 2001). We therefore investigated the amount of Mycoplasma hominis in LT broth, a nutritionally high-complex medium that we had evaluated for better and faster growth of anaerobes (Rieber et al, 2018). Using quantitative real-time PCR, a high bacterial concentration was detected (Table 1).…”

Section: Discussionsupporting

confidence: 71%

“…Aerobe and anaerobe culture on diverse agar plates remained sterile after 14 days of incubation. We have published detailed information about culture conditions for PJI elsewhere (Rieber et al, 2018). All specimens were cultured in the routinely used modified semifluid thioglycollate broth (LT) containing ox liver digest supplemented with horse serum and hemin (SIFIN, Berlin, Germany), and after seven days of incubation they all showed unevenly distributed turbidity due to agar content.…”

Section: Case Reportmentioning

confidence: 99%

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Periprosthetic joint infection associated with Mycoplasma hominis after transurethral instrumentation in an immunocompetent patient. Unusual or underestimated? A case report and review of the literature

Rieber¹,

Frontzek²,

Fischer

2019

International Journal of Infectious Diseases

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A B S T R A C TJudging by the small number of published cases, periprosthetic joint infections (PJI) caused by Mycoplasma species are regarded as unusual. This is not surprising as special growth conditions are necessary for diagnosis and therefore the laboratory must be informed of any clinical suspicion. However, surgeons are generally not aware of the risk factors associated with certain microorganisms causing an infection. Our laboratory therefore decided to adopt a new strategy: first, to address specific questions concerning the medical history of the patient and second, to make diagnosis of rare and fastidious microorganisms part of routine investigation, even if detailed information is not available.

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Section: Discussionsupporting

confidence: 71%

Section: Case Reportmentioning

confidence: 99%

Periprosthetic joint infection associated with Mycoplasma hominis after transurethral instrumentation in an immunocompetent patient. Unusual or underestimated? A case report and review of the literature

Rieber¹,

Frontzek²,

Fischer

2019

International Journal of Infectious Diseases

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“…The optimal BCB incubation time is a matter of debate [29]. Commonly, most BCBs with samples obtained from sterile sites are incubated for five days [30].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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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.

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“…While current guidelines do not provide any advice on the duration of empirical treatment, they do recommend bacterial cultivation time up to 14 days [2,3]. Keeping the cultures two weeks is sufficient to recover almost all of the bacteria conventionally involved in PJI, including anaerobes [12,17]. The isolation of C. acnes remains a difficult topic in implant-associated infections, but it seems that in proven PJI due to this bacteria, cultures are positive in 5 to 7 days, whereas they are positive later in cases of plate contamination [18,19].…”

Section: Discussionmentioning

confidence: 99%

The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections

Deroche

Bémer

Valentin

et al. 2019

JCM

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Currently, no guideline provides recommendations on the duration of empirical antimicrobial treatment (EAT) in prosthetic joint infection (PJI). The aim of our study was to describe the time to growth of bacteria involved in PJI, rendering possible decreased duration of EAT. Based on a French multicentre prospective cohort study, culture data from patients with confirmed hip or knee PJI were analysed. For each patient, five samples were processed. Time to positivity was defined as the first positive medium in at least one sample for virulent pathogens and as the first positive medium in at least two samples for commensals. Definitive diagnosis of polymicrobial infections was considered the day the last bacteria were identified. Among the 183 PJIs, including 28 polymicrobial infections, microbiological diagnosis was carried out between Day 1 (D1) and D5 for 96.7% of cases. There was no difference in the average time to positivity between acute and chronic PJI (p = 0.8871). Microbiological diagnosis was given earlier for monomicrobial than for polymicrobial infections (p = 0.0034). When an optimized culture of peroperative samples was carried out, almost all cases of PJI were diagnosed within five days, including polymicrobial infections. EAT can be re-evaluated at D5 according to microbiological documentation.

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Periprosthetic joint infection caused by anaerobes. Retrospective analysis reveals no need for prolonged cultivation time if sensitive supplemented growth media are used

Cited by 22 publications

References 17 publications

Periprosthetic joint infection associated with Mycoplasma hominis after transurethral instrumentation in an immunocompetent patient. Unusual or underestimated? A case report and review of the literature

Periprosthetic joint infection associated with Mycoplasma hominis after transurethral instrumentation in an immunocompetent patient. Unusual or underestimated? A case report and review of the literature

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

The Right Time to Safely Re-Evaluate Empirical Antimicrobial Treatment of Hip or Knee Prosthetic Joint Infections

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