Sonicate fluid inoculated into blood culture bottles does not improve diagnosis of periprosthetic joint infection caused by anaerobes. A retrospective analysis
| Autor: | Jörg Jerosch, Andre Frontzek, Rainer Weber, Sarah Götz, Ayman Sakkal, David Pfander, Andreas Breil-Wirth, Bertram Barden, Andreas Bell, Michael Alefeld, Martin Ulatowski, Stephanie Heinrich, Martin Fischer, Philip Kukuk, Heime Rieber, Hubertus Schmitt, Arjan Mullahi |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Microbiological Techniques Prosthesis-Related Infections Slackia exigua Periprosthetic Microbiology Incubation period 03 medical and health sciences Bacteria Anaerobic Sonication medicine Humans Blood culture Parvimonas micra Incubation 030304 developmental biology Aged Retrospective Studies Aged 80 and over 0303 health sciences medicine.diagnostic_test 030306 microbiology business.industry Bacterial Infections Middle Aged Antimicrobial Infectious Diseases Blood Culture Female Anaerobic bacteria business |
| Zdroj: | Anaerobe. 62 |
| ISSN: | 1095-8274 |
| Popis: | Background In microbiological diagnosis of periprosthetic joint infection (PJI) there is much controversial discussion about culture media and incubation time, especially if anaerobic bacteria are the causative agents. This retrospective analysis was conducted to compare the results obtained by inoculation of sonicate fluid from prosthetic components into BD Bactec blood culture bottles with those obtained by our culture method using sensitive supplemented growth media. Methods Twenty-eight cases were included in this study. For definition of PJI, the criteria of the Musculoskeletal Infection Society (MSIS) were considered. The quantity and time to positivity of anaerobes detected in sonicate fluid were monitored both from inoculated supplemented liver thioglycollate broth and anaerobic blood culture bottles. Furthermore, phenotypic testing was performed on the antimicrobial activity within the sonicate fluid. Results The most frequently isolated microbes were Cutibacterium species, followed by Finegoldia magna, Parvimonas micra, Robinsoniella peoriensis, Clostridium species, Peptoniphilus harei and Slackia exigua. In 24 cases, the microorganisms became detectable within five days (median time 3.2 days) when sonicate fluid was incubated in supplemented liver thioglycollate broth, regardless of whether the patients had taken antimicrobial agents prior to surgery. However, when sonicate fluid was inoculated into anaerobic Bactec bottles, the median time to positivity was 7.4 days and only 12 cases (43%) were correctly identified. Sixteen cases remained negative after 14 days of incubation. Conclusion Depending on the pathogen, incubation of sonicate fluid using blood culture bottles can support diagnosis of PJI but compared with our culture medium it is less efficient if anaerobes are the suspected cause of infection. Microbiological expertise is therefore indispensable to ensure reliable detection of these microorganisms in PJI until a gold standard for laboratory handling of anaerobes has been established. |
| Databáze: | OpenAIRE |
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