Abstract
Background. Identifying the microorganism in a prosthetic joint infection is the key to appropriately targeting antimicrobial treatment. Despite the availability of various techniques, no single test is considered the definitive gold standard. Aim. Our aim was to determine the sensitivity, specificity, and positive/negative predictive values for a variety of culture techniques. Methods. We performed a retrospective case series of 219 patients undergoing revision surgery of their hip or knee replacement between May 2004 and February 2013. The patients were classified as either infected or noninfected according to criteria set out by the Musculoskeletal Infection Society. The number and type of samples taken intraoperatively varied between cases but included tissue samples and fluid sent in either blood culture vials or sterile containers. Results. The highest sensitivity was found with blood culture vials (0.85) compared to fluid in sterile containers (0.26) and tissues samples (0.32). Blood culture vials also had a better specificity and positive and negative predictive values profile. Conclusion. We conclude that, of the techniques studied, fluid in blood culture vials had the best profile for the correct identification of microorganisms and advocate its use.
Highlights
The incidence of infection after primary joint replacement has been reported at 1% to 4% [1,2,3,4,5,6]
A microorganism was identified in 91% of infected cases with four cases having multiple organisms
Detecting the correct microorganism is essential for the targeted use of antibiotics following revision in prosthetic joint infections
Summary
The incidence of infection after primary joint replacement has been reported at 1% to 4% [1,2,3,4,5,6]. Traditional recommendations for microbiological culture suggest taking five or six tissue samples during revision surgery with a definite diagnosis being represented by three or more positive results [9]. A number of studies have reported low sensitivities of tissue sampling, [9,10,11] and a more reliable test for identifying the correct microorganism is desirable. Identifying the microorganism in a prosthetic joint infection is the key to appropriately targeting antimicrobial treatment. The highest sensitivity was found with blood culture vials (0.85) compared to fluid in sterile containers (0.26) and tissues samples (0.32). Of the techniques studied, fluid in blood culture vials had the best profile for the correct identification of microorganisms and advocate its use
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
