Improving the microbiological diagnosis of fracture-related infection and prosthetic joint infection through culturing sonication fluid in Bactec blood culture bottles.

IF 2.1 4区 生物学 Q3 MICROBIOLOGY
Anderson X B Velasquez, Giselle B Klautau, Mariana Neri L Kurihara, Ingrid Nayara M Santos, Laura B Campos, Mayara Muniz Silva, Icaro S Oliveira, Thomas Stravinskas Durigon, Lais S Seriacopi, Mauro J Salles
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引用次数: 0

Abstract

Background: Sonication of surgically removed implants appears to optimize the microbiological diagnosis in orthopedic implant-associated infections (OIAI). However, reports of infection with negative cultures can still reach high rates. A study evaluating the inoculation of sonication fluid into blood culture bottles (SFBCB) in patients with fracture-related infection (FRI) and prosthetic joint infection (PJI) is necessary. This study compared the accuracy SFBCB over the conventional sonication fluid cultures (CSFC) and tissue culture (TC).

Methods: Consecutive patients who underwent implant removal surgeries due to any reason had their implants sonicated according to standardized method. Definitions of PJI and FRI were based upon criteria by European Bone and Joint Infection Society (EBJIS) and Metsemakers, respectively. Between three to five intraoperative tissue samples were processed. The implant`s sonication fluid was seeded onto sheep blood agar, chocolate agar, thioglycolate broth and on tryptic soy broth for CSFC, while was also inoculated into blood culture bottles and incubated in the automated system during 5 days for SFBCB.

Results: Overall, 74 patients were analyzed, of which 57 with OIAI (48 FRI and 09 PJI) and 17 aseptic failures (03 arthroplasties and 14 osteosynthesis). Interestingly, SFBCB demonstrated significantly higher sensitivity compared to CSFC (96.5% [95% CI, 88-100] vs. 78.9% [95% CI, 66-89], p = 0.004), and to TC (96.5% [95% CI, 88-100], vs. 57.9% [95% CI, 44-71], p < 0.001), whereas there were no significant differences in specificity between the three methods.

Conclusion: In comparison to CSFC and TC, SFBCB improved sensitivity for diagnosing OIAI without compromising specificity.

通过在 Bactec 血液培养瓶中培养超声液,改进骨折相关感染和人工关节感染的微生物诊断。
背景:对手术取出的植入物进行超声处理似乎能优化骨科植入物相关感染 (OIAI) 的微生物诊断。然而,阴性培养的感染率仍然很高。有必要对骨折相关感染(FRI)和人工关节感染(PJI)患者将超声液接种到血培养瓶(SFBCB)中进行评估研究。本研究比较了 SFBCB 与传统超声流体培养(CSFC)和组织培养(TC)的准确性:方法:因任何原因接受假体移除手术的连续患者均按照标准方法对其假体进行超声处理。PJI和FRI的定义分别基于欧洲骨与关节感染学会(EBJIS)和Metsemakers的标准。术中处理了三到五个组织样本。对于 CSFC,将植入物超声处理液接种到羊血琼脂、巧克力琼脂、巯基乙酸肉汤和胰酪大豆肉汤中;对于 SFBCB,则将其接种到血液培养瓶中并在自动系统中培养 5 天:共分析了 74 例患者,其中 57 例为 OIAI(48 例 FRI 和 09 例 PJI),17 例为无菌失败(03 例关节置换和 14 例骨合成)。有趣的是,与 CSFC(96.5% [95% CI, 88-100] vs. 78.9% [95% CI, 66-89],p = 0.004)和 TC(96.5% [95% CI, 88-100] vs. 57.9% [95% CI, 44-71],p 结论:与 CSFC 和 TC 相比,SFBCB 的灵敏度明显更高:与CSFC和TC相比,SFBCB提高了诊断OIAI的灵敏度,但特异性并未降低。
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来源期刊
Brazilian Journal of Microbiology
Brazilian Journal of Microbiology 生物-微生物学
CiteScore
4.10
自引率
4.50%
发文量
216
审稿时长
1.0 months
期刊介绍: The Brazilian Journal of Microbiology is an international peer reviewed journal that covers a wide-range of research on fundamental and applied aspects of microbiology. The journal considers for publication original research articles, short communications, reviews, and letters to the editor, that may be submitted to the following sections: Biotechnology and Industrial Microbiology, Food Microbiology, Bacterial and Fungal Pathogenesis, Clinical Microbiology, Environmental Microbiology, Veterinary Microbiology, Fungal and Bacterial Physiology, Bacterial, Fungal and Virus Molecular Biology, Education in Microbiology. For more details on each section, please check out the instructions for authors. The journal is the official publication of the Brazilian Society of Microbiology and currently publishes 4 issues per year.
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