Time to positivity of acute and chronic periprosthetic joint infection cultures

• Published in: Diagnostic microbiology and infectious disease 2021-01, Vol.99 (1), p.115178-115178, Article 115178
• Main Authors: Talsma, D.T., Ploegmakers, J.J.W., Jutte, P.C., Kampinga, G., Wouthuyzen-Bakker, M.
• Format: Article
• Language: English
• Subjects: Acute; Chronic; Diagnosis; Periprosthetic joint infection; Sonication; Time to positivity
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2020.115178

A prolonged incubation time is generally recommended for diagnosing periprosthetic joint infections (PJI). However, in literature, no distinction is made between acute and chronic infections. All patients with a PJI that underwent surgical debridement between November 2015 and February 2019 with or without revision of the prosthesis were retrospectively evaluated. Synovial fluid, 5 intraoperative periprosthetic tissue samples, and the sonicated prosthesis were cultured. Fifty-nine patients were analyzed, including 21 acute PJIs (33 isolates) and 38 chronic PJIs (46 isolates). In acute PJIs, all isolates grew within 5 days, while this took 11 days for chronic PJIs. Sonication fluid showed the shortest time to positivity (78% at day 2) for chronic PJIs, but no difference was observed for acute PJIs compared to tissue cultures. In contrast to cultures from chronic PJIs, acute PJIs do not need a prolonged incubation time and no clear benefit is observed for sonication. •Time to positivity is shorter for acute prosthetic joint infection cultures.•Prolonged empiric therapy is unnecessary in acute prosthetic joint infection.•Sonication has less benefit in acute prosthetic joint infection cultures.•Acute and chronic prosthetic joint infections are different laboratory entities.