Advertisement

Microbiological Processing of Samples in the Investigation of Suspected Prosthetic Joint Infection

  • David G. Partridge
  • Rob Towsend
Chapter

Abstract

Microbiological diagnosis is the most important issue in the evaluation of a PJI. It guides further treatment. The outcomes of PJI treatment reflect the quality if the initial microbiological assessment. Aspiration and tissue cultures are still the most important samples for microbiological evaluation of PJI. The chapter presents the appropriate workout for the specimens and the potential pitfalls in the sampling and handling of specimens obteined for microbiological analysis.

Keywords

Sampling Bacterial cultures Identification Susceptibility 

References

  1. 1.
    Stefansdottir A, Johansson D, Knutson K, Lidgren L, Robertsson O. Microbiology of the infected knee arthroplasty: report from the Swedish Knee Arthroplasty Register on 426 surgically revised cases. Scand J Infect Dis. 2009;41(11–12):831–40. doi: 10.3109/00365540903186207.PubMedCrossRefGoogle Scholar
  2. 2.
    Fink B, Makowiak C, Fuerst M, Berger I, Schafer P, Frommelt L. The value of synovial biopsy, joint aspiration and C-reactive protein in the diagnosis of late peri-prosthetic infection of total knee replacements. J Bone Joint Surg Br. 2008;90(7):874–8. doi: 10.1302/0301-620X.90B7.20417. PII:90-B/7/874.PubMedCrossRefGoogle Scholar
  3. 3.
    Del Pozo JL, Patel R. Clinical practice. Infection associated with prosthetic joints. N Engl J Med. 2009;361(8):787–94. doi: 10.1056/NEJMcp0905029. PII:361/8/787.PubMedCrossRefGoogle Scholar
  4. 4.
    Trampuz A, Piper KE, Jacobson MJ, Hanssen AD, Unni KK, Osmon DR, Mandrekar JN, Cockerill FR, Steckelberg JM, Greenleaf JF, Patel R. Sonication of removed hip and knee prostheses for diagnosis of infection. N Engl J Med. 2007;357(7):654–63. doi: 10.1056/NEJMoa061588. PII:357/7/654.PubMedCrossRefGoogle Scholar
  5. 5.
    Della Valle C, Parvizi J, Bauer TW, DiCesare PE, Evans RP, Segreti J, Spangehl M, Watters 3rd WC, Keith M, Turkelson CM, Wies JL, Sluka P, Hitchcock K. American Academy of Orthopaedic Surgeons clinical practice guideline on: the diagnosis of periprosthetic joint infections of the hip and knee. J Bone Joint Surg Am. 2011;93(14):1355–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Moran E, Byren I, Atkins BL. The diagnosis and management of prosthetic joint infections. J Antimicrob Chemother. 2010;65 Suppl 3:iii45–54. doi: 10.1093/jac/dkq305. PII:dkq305.PubMedCrossRefGoogle Scholar
  7. 7.
    Health Protection Agency. Investigation of prosthetic joint infection samples. National Standard Method BSOP 44 Issue 1.1. 2009.Google Scholar
  8. 8.
    Holinka J, Bauer L, Hirschl AM, Graninger W, Windhager R, Presterl E. Sonication cultures of explanted components as an add-on test to routinely conducted microbiological diagnostics improve pathogen detection. J Orthop Res. 2011;29(4):617–22.PubMedCrossRefGoogle Scholar
  9. 9.
    Khater FJ, Samnani IQ, Mehta JB, Moorman JP, Myers JW. Prosthetic joint infection by Mycobacterium tuberculosis: an unusual case report with literature review. South Med J. 2007;100(1):66–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Atkins BL, Athanasou N, Deeks JJ, Crook DW, Simpson H, Peto TE, McLardy-Smith P, Berendt AR. Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty. The OSIRIS Collaborative Study Group. J Clin Microbiol. 1998;36(10):2932–9.PubMedGoogle Scholar
  11. 11.
    Brook I. Comparison of two transport systems for recovery of aerobic and anaerobic bacteria from abscesses. J Clin Microbiol. 1987;25(10):2020–2.PubMedGoogle Scholar
  12. 12.
    Hughes HC, Newnham R, Athanasou N, Atkins BL, Bejon P, Bowler IC. Microbiological diagnosis of prosthetic joint infections: a prospective evaluation of four bacterial culture media in the routine laboratory. Clin Microbiol Infect. 2011;17(10):1528–30.PubMedCrossRefGoogle Scholar
  13. 13.
    Bergamini TM, Bandyk DF, Govostis D, Vetsch R, Towne JB. Identification of Staphylococcus epidermidis vascular graft infections: a comparison of culture techniques. J Vasc Surg. 1989;9(5):665–70. PII:S0741-5214(89)70037-9.PubMedGoogle Scholar
  14. 14.
    Butler-Wu SM, Burns EM, Pottinger PS, Magaret AS, Rakeman JL, Matsen 3rd FA, Cookson BT. Optimization of periprosthetic culture for diagnosis of Propionibacterium acnes prosthetic joint infection. J Clin Microbiol. 2011;49(7):2490–5. doi: 10.1128/JCM.00450-11. PII:JCM.00450-11.PubMedCrossRefGoogle Scholar
  15. 15.
    Bailey C, Duckett S, Davies S, Townsend R, Stockley I. Haemophilus parainfluenzae prosthetic joint infection. The importance of accurate microbiological diagnosis and options for management. J Infect. 2011;63(6):474–6. doi: 10.1016/j.jinf.2011.08.009. PII:S0163-4453(11)00461-0.PubMedCrossRefGoogle Scholar
  16. 16.
    Harris LG, El-Bouri K, Johnston S, Rees E, Frommelt L, Siemssen N, Christner M, Davies AP, Rohde H, Mack D. Rapid identification of staphylococci from prosthetic joint infections using MALDI-TOF mass-spectrometry. Int J Artif Organs. 2010;33(9):568–74. PII:2213A231-7A27-44BF-A569-CAC6A2777982.PubMedGoogle Scholar
  17. 17.
    Fenollar F, Roux V, Stein A, Drancourt M, Raoult D. Analysis of 525 samples to determine the usefulness of PCR amplification and sequencing of the 16S rRNA gene for diagnosis of bone and joint infections. J Clin Microbiol. 2006;44(3):1018–28. doi: 10.1128/JCM.44.3.1018-1028.2006. PII:44/3/1018.PubMedCrossRefGoogle Scholar
  18. 18.
    Fihman V, Hannouche D, Bousson V, Bardin T, Liote F, Raskine L, Riahi J, Sanson-Le Pors MJ, Bercot B. Improved diagnosis specificity in bone and joint infections using molecular techniques. J Infect. 2007;55(6):510–7. doi: 10.1016/j.jinf.2007.09.001. PII:S0163-4453(07)00755-4.PubMedCrossRefGoogle Scholar
  19. 19.
    Panousis K, Grigoris P, Butcher I, Rana B, Reilly JH, Hamblen DL. Poor predictive value of broad-range PCR for the detection of arthroplasty infection in 92 cases. Acta Orthop. 2005;76(3):341–6.PubMedGoogle Scholar
  20. 20.
    Gallo J, Kolar M, Dendis M, Loveckova Y, Sauer P, Zapletalova J, Koukalova D. Culture and PCR analysis of joint fluid in the diagnosis of prosthetic joint infection. New Microbiol. 2008;31(1):97–104.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  1. 1.Infectious Diseases and Microbiology, Sheffield Teaching Hospitals NHS TrustSheffieldUK

Personalised recommendations