Improvement in the detection rate of PJI in total hip arthroplasty through multiple sonicate fluid cultures

ABSTRACT The microbiological culture of sonicate fluid (SFC) of explanted endoprosthetic components has increased the rate of bacterial isolation in comparison to conventional microbiological methods. However, this creates the problem of interpreting cases of singular bacterial isolation through SFC...

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Bibliographic Details
Published in:Journal of orthopaedic research 2013-12, Vol.31 (12), p.2021-2024
Main Authors: Janz, V., Wassilew, G.I., Hasart, O., Tohtz, S., Perka, C.
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Hip - adverse effects
Bacteria - isolation & purification
Bacteriological Techniques - methods
Humans
Joint Diseases - diagnosis
periprosthetic joint infection (PJI)
Prospective Studies
Prosthesis-Related Infections - diagnosis
Sensitivity and Specificity
sonication
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Summary:ABSTRACT The microbiological culture of sonicate fluid (SFC) of explanted endoprosthetic components has increased the rate of bacterial isolation in comparison to conventional microbiological methods. However, this creates the problem of interpreting cases of singular bacterial isolation through SFC, while all other microbiological samples remain negative. The aim of this study was to reference these singular positive SFC against, the histological classification of the periprosthetic membrane (PM), and the utilization of multiple SFC (separate sonication of individual endoprosthetic components). In this prospective study we compared the effect of multiple SFC for detection of periprosthetic joint infection (PJI) in patients with total hip revision surgery. All microbiological results were referenced against PM. Of the 102 cases there were 37 cases of PJI. Single SFC achieved the highest sensitivity of all individual parameters with 89% and a specificity of 72%. When multiple SFC were employed the sensitivity and specificity increased to 100%. There was a concordance of 86% between the PM and SFC. SFC achieved the highest sensitivity and it was possible to further improve the sensitivity and specificity when using multiple cultures. Multiple SFC and PM are beneficial to help reference singular bacterial isolations and achieve the diagnosis of PJI. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:2021–2024, 2013
ISSN:0736-0266
1554-527X
DOI:10.1002/jor.22451