Microbiological diagnosis of polymicrobial periprosthetic joint infection revealed superiority of investigated tissue samples compared to sonicate fluid generated from the implant surface
Objectives
In microbiological diagnosis of periprosthetic joint infection (PJI) there is much discussion about the methodology of obtaining proper specimens, processing technique and suitable culture media. This retrospective study was conducted to analyze the accuracy of our cultivation techniques.
Methods
We investigated tissue samples and components from 258 patients after revision arthroplasty of the hip, knee and shoulder to compare the results of tissue cultures (TC) with those of sonicate fluid cultures (SFC). Furthermore, we wanted to evaluate the influence of different culture media on the detection rate.
Results
PJI was confirmed in 186 patients. The overall sensitivity of TC was no different to that of SFC (91.3% versus 90.8%, P = 1). In 153 cases (82.3%) concordant positive TC and SFC were conducted. In 33 cases (17.7%) discordant results were achieved. When differentiated according to type of infection, TC showed significantly better results detecting polymicrobial infections (97.0% versus 67.0%, P = 0.004). There were also significant differences between the culture media regarding the yield of microorganisms.
Conclusion
TC was more effective in detecting coinfections. The best results were obtained using both TC and SFC. The choice of culture media has a decisive influence on the quality of results.
Publisher URL: https://www.sciencedirect.com/science/article/pii/S1201971221003039
Open URL: https://doi.org/10.1016/j.ijid.2021.03.085
DOI: 10.1016/j.ijid.2021.03.085
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