Is sonication of antibiotic-loaded cement spacers useful in two-stage revision of prosthetic joint infection?
| Autor: | Andrea Sambri, Dante Dallari, Giuseppe Bianchi, Annalisa Pederzoli, Maria Elena Donati, Elisa Storni, Alessandra Maso, Davide Maria Donati |
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| Přispěvatelé: | Sambri, Andrea, Maso, Alessandra, Storni, Elisa, Donati, Maria Elena, Pederzoli, Annalisa, Dallari, Dante, Bianchi, Giuseppe, Donati, Davide Maria |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Reoperation Microbiology (medical) Prosthetic joint infection medicine.medical_specialty Prosthesis-Related Infections Microbiological culture Spacer medicine.medical_treatment Sonication Periprosthetic Gram-Positive Bacteria Microbiology Prosthesis Two stage revision Young Adult 03 medical and health sciences Exchange protocol Humans Medicine Molecular Biology Antibiotic loaded cement Aged 030304 developmental biology Aged 80 and over 0303 health sciences 030306 microbiology business.industry Middle Aged Surgery Female Hip Prosthesis Joint Diseases Knee Prosthesis business Diagnosi |
| Zdroj: | Journal of Microbiological Methods. 156:81-84 |
| ISSN: | 0167-7012 |
| DOI: | 10.1016/j.mimet.2018.12.006 |
| Popis: | Background In a two-stage exchange protocol for prosthetic joint infection (PJI), bacteria surviving over the antibiotic-loaded cement spacers may cause the persistence of infection with renewed clinical symptoms following the surgery. Culture after sonication of removed prosthesis is more sensitive than conventional periprosthetic tissue culture for the microbiological diagnosis of PJI. The aim of this study was to assess whether sonication of the spacer at the time of the second-stage procedure may improve the diagnosis of persistent PJI. Methods We evaluated by microbiological culture the sonication fluid from 222 cement spacers implanted in a two-stage exchange protocol in 157 patients affected by PJI. A mean of 1.3 (range, 1–4) spacer per patient was performed. Results In 53 out of 222 spacers analyzed infection was confirmed according to the MSIS criteria. In 22 cases the infection was confirmed by both cultures on periprosthetic tissue and on sonication fluid from the spacers. In 23 cases persistent PJI was identified because of only cultures of periprosthetic tissue and 8 because of results obtained after spacer sonication. The sensitivity of periprosthetic tissue cultures was higher than that of cultures performed on sonication fluid (84.9% vs 56.6%, p Conclusions Even though sonication of cement spacers has performances inferior than those reported for prosthesis, it can be considered a complementary method to unravel persistent infection during a two-stage exchange protocol for PJI. |
| Databáze: | OpenAIRE |
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