Abstract
BackgroundBlood 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.MethodsThe 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.ResultsThe 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).ConclusionWe 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.
Highlights
Blood culture bottles (BCBs) provide a semiautomated method for culturing periprosthetic tissue specimens
There were no ethical issues to consider due to use of anonymous clinical samples and development of methodological procedures
For the BacT/Alert FN Plus bottles inoculated with anaerobic bacteria, there was a remarkable difference in Time to detection (TTD) between the two strains tested
Summary
Blood culture bottles (BCBs) provide a semiautomated method for culturing periprosthetic tissue specimens. The scheme currently in use combines clinical findings and laboratory results [10] where the microbiological assessment of periprosthetic tissue is an important criterion for diagnosis of PJI [4, 10, 11]. Most clinical microbiology laboratory diagnostic methods for PJI are based on culturing bacteria on agar plate and in enrichment broth. These methods are labor intensive, involve subculturing and require daily inspection of enrichment broths. Low sensitivity and lack of specificity leads to 10 to 30% false-negative results [3, 12]. Improved methods for culturing periprosthetic tissue for diagnosis of PJI are urgently needed
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