Efficacy of thermal analysis in the detection of bacterial strains in periprosthetic joint infections

Abstract

In musculoskeletal surgery, joint and periprosthetic infections are rare but significant complications with a high risk of morbidity. Rapid diagnosis, surgical intervention and definitive antibiotic therapy are key factors to the success of the treatment and the recovery of former limb function. In addition to the current diagnostic procedures, there is a need to introduce new, therapy-centered diagnostic procedures in view of the increase in antibiotic resistance. In our current study, we set out to demonstrate the practical utility of differential scanning calorimetry and the isoperibolic calorimetry in diagnostics of joint and periprosthetic infections. We have shown significant differences among the different grade of arthritis. Under experimental conditions, synovial fluid samples were artificially superinfected with the most frequently occurring bacteria at a concentration of 103–105 CFU mL−1 and monitored in isothermal mode at 37 °C. The isoperibolic tests clearly showed a specific, concentration-dependent representative curve (duration of proliferation and its maximum rates) for each bacterial strain of the study. In our opinion, the different thermal analytical methods can be useful in the diagnosis of septic inflammatory processes and, in the rapid selection of definitive antibiotic therapy.