The utility of dithiothreitol treatment of periprosthetic tissues and explanted implants in the diagnosis of prosthetic joint infection

Sebastian, Sujeesh; Malhotra, Rajesh; Sreenivas, Vishnubhatla; Kapil, Arti; Dhawan, Benu

doi:10.1016/j.ijmmb.2020.12.004

Cited by 4 publications

(3 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Using the MSIS definition of IAP, both methods, SFC and DTT, demonstrated similar sensitivity rates of 85.3% (29/34) and 82.4% (28/34) ( p > 0.05) (analysis performed with STATA software version 14.2 - Stata Corp LLC; Texas, USA), respectively. Although not statistically significant, the specificity was greater when using the SFC technique (100%, 39/39 vs. 97.4%, 38/39 p > 0.99) ( Sebastian et al., 2021 ).…”

Section: The Ability Of Sonication Protocols To Dislodge Biofilm Stru...mentioning

confidence: 99%

“…Even in one study that showed a loss of specificity, sonication provided a more reliable diagnosis of PJI, as it identified more pathogens than DTT treatment ( Karbysheva et al., 2022 ). However, given the positive impacts that chemical methods can have on the diagnosis of these infections, especially on culture specificity, DTT treatment could be used as a biofilm displacement technique in situations where sonication is not viable or possible ( Sebastian et al., 2021 ). It is also possible to evaluate the potential additive effect of chemical shift on sonication ( Karbysheva et al., 2020 ).…”

Section: The Ability Of Sonication Protocols To Dislodge Biofilm Stru...mentioning

confidence: 99%

See 1 more Smart Citation

Sonication protocols and their contributions to the microbiological diagnosis of implant-associated infections: a review of the current scenario

Silva,

De Melo,

Oliva

et al. 2024

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Addressing the existing problem in the microbiological diagnosis of infections associated with implants and the current debate about the real power of precision of sonicated fluid culture (SFC), the objective of this review is to describe the methodology and analyze and compare the results obtained in current studies on the subject. Furthermore, the present study also discusses and suggests the best parameters for performing sonication. A search was carried out for recent studies in the literature (2019-2023) that addressed this research topic. As a result, different sonication protocols were adopted in the studies analyzed, as expected, and consequently, there was significant variability between the results obtained regarding the sensitivity and specificity of the technique in relation to the traditional culture method (periprosthetic tissue culture – PTC). Coagulase-negative Staphylococcus (CoNS) and Staphylococcus aureus were identified as the main etiological agents by SFC and PTC, with SFC being important for the identification of pathogens of low virulence that are difficult to detect. Compared to chemical biofilm displacement methods, EDTA and DTT, SFC also produced variable results. In this context, this review provided an overview of the most current scenarios on the topic and theoretical support to improve sonication performance, especially with regard to sensitivity and specificity, by scoring the best parameters from various aspects, including sample collection, storage conditions, cultivation methods, microorganism identification techniques (both phenotypic and molecular) and the cutoff point for colony forming unit (CFU) counts. This study demonstrated the need for standardization of the technique and provided a theoretical basis for a sonication protocol that aims to achieve the highest levels of sensitivity and specificity for the reliable microbiological diagnosis of infections associated with implants and prosthetic devices, such as prosthetic joint infections (PJIs). However, practical application and additional complementary studies are still needed.

show abstract

Section: The Ability Of Sonication Protocols To Dislodge Biofilm Stru...mentioning

confidence: 99%

Section: The Ability Of Sonication Protocols To Dislodge Biofilm Stru...mentioning

confidence: 99%

Sonication protocols and their contributions to the microbiological diagnosis of implant-associated infections: a review of the current scenario

Silva,

De Melo,

Oliva

et al. 2024

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

show abstract

“…D-L dithiothreitol (DTT) is a sulfhydryl compound able to reduce disulfide bounds between polysaccharides and neighbor proteins, thus acting as an antibiofilm agent, without any toxicity on the living bacteria, if used at the right concentrations and time [15]. As such, DTT has been shown to increase the sensitivity of microbiological cultures both when applied to retrieved joint prosthetic implants and to the periprosthetic tissues [16][17][18][19], and even in cardiac valves [20].…”

Section: Introductionmentioning

confidence: 99%

Dithiotreitol pre-treatment of synovial fluid samples improves microbiological counts in peri-prosthetic joint infection

Drago

Romanò

Fidanza

et al. 2023

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Synovial fluid cultures of periprosthetic joint infections (PJI) may be limited by bacteria living in the fluids as biofilm-aggregates. The antibiofilm pre-treatment of synovial fluids with dithiotreitol (DTT) could improve bacterial counts and microbiological early stage diagnosis in patients with suspected PJI. Methods Synovial fluids collected from 57 subjects, affected by painful total hip or knee replacement, were divided into two aliquots, one pre-treated with DTT and one with normal saline. All samples were plated for microbial counts. Sensitivity of cultural examination and bacterial counts of pre-treated and control samples were then calculated and statistically compared. Results Dithiothreitol pre-treatment led to a higher number of positive samples, compared to controls (27 vs 19), leading to a statistically significant increase in the sensitivity of the microbiological count examination from 54.3 to 77.1% and in colony-forming units count from 1884 ± 2.129 CFU/mL with saline pre-treatment to 20.442 ± 19.270 with DTT pre-treatment (P = 0.02). Conclusions To our knowledge, this is the first report showing the ability of a chemical antibiofilm pre-treatment to increase the sensitivity of microbiological examination in the synovial fluid of patients with peri-prosthetic joint infection. If confirmed by larger studies, this finding may have a significant impact on routine microbiological procedures applied to synovial fluids and brings further support to the key role of bacteria living in biofilm-formed aggregates in joint infections.

show abstract

Is sonication superior to dithiothreitol in diagnosis of periprosthetic joint infections? A meta-analysis

Tsikopoulos

Christofilos

Kitridis

et al. 2022

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

The utility of dithiothreitol treatment of periprosthetic tissues and explanted implants in the diagnosis of prosthetic joint infection

Cited by 4 publications

References 31 publications

Sonication protocols and their contributions to the microbiological diagnosis of implant-associated infections: a review of the current scenario

Sonication protocols and their contributions to the microbiological diagnosis of implant-associated infections: a review of the current scenario

Dithiotreitol pre-treatment of synovial fluid samples improves microbiological counts in peri-prosthetic joint infection

Is sonication superior to dithiothreitol in diagnosis of periprosthetic joint infections? A meta-analysis

Contact Info

Product

Resources

About