Prolonged Bacterial Culture to Identify Late Periprosthetic Joint Infection: A Promising Strategy

Schäfer, Peter; Fink, Bernd; Sandow, D; Margull, Andreas; Berger, Irina; Frommelt, Lars

doi:10.1086/592973

Cited by 472 publications

(330 citation statements)

References 35 publications

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“…acnes required prolonged incubation in the laboratory to detect growth, 5 to 13 days; similar ranges are supported by other studies [21,26,36]. In most clinical laboratories in the United States, conventional cultures are held only for 5 days [19].…”

Section: Discussionsupporting

confidence: 61%

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

Millett

Yen

Price

et al. 2011

Clinical Orthopaedics &Amp; Related Research

110

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Section: Discussionsupporting

confidence: 61%

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

Millett

Yen

Price

et al. 2011

Clinical Orthopaedics &Amp; Related Research

110

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“…Antibiotics were not administered until specimens were obtained for microbiological testing. Time of incubation was extended from ten to 14 days to enhance sensitivity [18]. In chronic cases when antibiotics had already been administered by the transferring hospital, and if clinically possible, treatment was paused for two to four weeks to avoid pathogen suppression in microbiological testing.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections

Wimmer

Randau

Petersdorf

et al. 2013

International Orthopaedics (SICOT)

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Purpose Current concepts in the treatment of prosthetic joint infections include prosthetic retention and exchange strategies according to published recommendations. A useful algorithm should fit for each type of prosthetic joint infection, even the most complicated situations. We present the outcome of 147 patients with prosthetic joint infections of the hip or the knee joint in an unselected population in clinical routine. Methods Between November 2006 and November 2009, 147 consecutive patients with prosthetic joint infections of the hip or knee were treated according to an algorithm based on the concept published by Zimmerli et al. in 2004. Causative organism, duration of infection, patient comorbidities, surgical treatment, antibiotic treatment, and outcome of treatment were analysed retrospectively. According to the criteria duration of infection, stability of prosthesis, local and systemic risk factors, and susceptibility of the causative pathogen, patients were treated either with debridement and retention or a longinterval two-stage procedure. Results A pathogen could be detected in 82.8 % of the patients, gram-positive cocci being most common. Twentyseven patients were treated with debridement and retention and 120 were treated with a two-stage procedure. In 68 cases difficult-to-treat pathogens could be detected, a polymicrobial infection was found in 51 patients. Definitely free of infection were 71.6 % after a two-stage procedure, and 70.4 % after debridement and retention. Conclusions Our data indicates that the applied algorithm is suitable to be applied as a day-to-day routine, and we confirmed that published results from the literature can be reproduced in an inhomogeneous patient cohort.

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“…In both, coagulase-negative Staphylococcus grew in the intraoperative sample cultures, and histological examination was positive for infection. Our false negative cannot be attributed to the culture technique, since we used enrichment culture media, sub-cultured growth in liquid media, and followed a prolonged (14 day) culture protocol [16].…”

Section: Discussionmentioning

confidence: 97%

“…We have used intraoperative tissue samples as our gold standard, even though in some series the rate of false negative cultures has been as high as 10% [23]. In truth, there is currently no certain alternative to intraoperative sampling, and there will not be, as long as the roles of other techniques such as sonication and molecular techniques remain undefined, and until prolonged culture protocols and enriched media have decreased the rate of culture-negative PJI [16].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous interface biopsy in dry-aspiration cases of chronic periprosthetic joint infections: A technique for preoperative isolation of the infecting organism

Corona

Gil

Guerra

et al. 2011

International Orthopaedics (SICOT)

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Purpose Preoperative identification of the infecting microorganism is of paramount importance in the treatment protocol for chronic periprosthetic joint infections, as it enables selection of the most appropriate antibiotic treatment. Preoperative joint aspiration, the most commonly used sampling technique, has proven to have a broad range of sensitivity values and the frequency of dry aspirations has not been well assessed. In such dry-tap cases a biopsy sample could be an option. The purpose of this study was to assess the diagnostic accuracy of percutaneous interface biopsy (PIB) in isolating the infecting organism in cases of chronic Periprosthetic Joint Infection (PJI) and dry-tap event. The basic technique is to harvest and culture a sample from the periprosthetic interface membrane by a percutaneous technique in the preoperative period. Methods A retrospective study was done involving 24 consecutive patients suspected of PJI and where no fluid was obtained from the joint. Culture results from a percutaneous interface biopsy (PIB) were compared with intraoperative tissue cultures at the time of revision surgery. In all cases, a two-stage replacement was done. Results The sensitivity was 88.2%; specificity was 100%. Positive predictive value was 100%, while negative predictive value was 77.9%. Accuracy was 91.6%. No technique-related complication was observed. Conclusion We conclude that PIB is a useful test for preoperative isolation of the infecting organism and could play a role in cases with dry-tap joint aspirations.

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Prolonged Bacterial Culture to Identify Late Periprosthetic Joint Infection: A Promising Strategy

Abstract: Prolonged microbiological culture for 2 weeks is promising because it yields signs of periprosthetic infection in a significant proportion of patients that would otherwise remain unidentified.

Cited by 472 publications

References 35 publications

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections

Percutaneous interface biopsy in dry-aspiration cases of chronic periprosthetic joint infections: A technique for preoperative isolation of the infecting organism

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