Sonication Cultures of Explanted Components as an Add-On Test to Routinely Conducted Microbiological Diagnostics Improve Pathogen Detection
Sonication Cultures of Explanted Components as an Add-On Test to Routinely Conducted Microbiological Diagnostics Improve Pathogen Detection
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DOI：
10.1002/jor.21286
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发表时间：
2011-04-01
影响因子：
2.8
通讯作者：
Presterl, Elisabeth
中科院分区：
文献类型：
--
作者：
Holinka, Johannes;Bauer, Leonhard;Presterl, Elisabeth
本研究的目的是提高人工关节感染的病原体检测，特别是评估超声培养法在临床常规中的可行性。对所有可能存在假体或种植体感染的患者的取出部件分别在无菌容器中进行超声处理，以去除表面粘附的细菌并进行培养。比较了超声培养与常规组织培养的结果。我们研究了60例假体或植入物松动的连续患者。40例患者发生感染性松动和20例无菌性松动（24例膝关节假体，21例髋关节假体，6例巨型假体，2例肩关节假体，6例骨接合术，1例脊柱内固定术）。超声液体培养的敏感性为83.3%，单一阳性组织培养的敏感性为72.2%，两种或两种以上培养结果相同时的敏感性为61.1%。在接受抗生素治疗的患者中，敏感性分别为65.9%、57.5%和42.5%。在单一组织培养以及超声培养中检测到的病原体产生的假体感染率显著高于单独的传统组织培养（p = 0.008），即使在假体置换前接受连续抗生素治疗的患者中也是如此（p = 0.016）。与传统的组织培养相比，超声处理方法代表了病原体检测中的一个重要附加项。(C)2010骨科研究学会。出版社：Wiley Periodicals，Inc. J Orthop Res 29：617-622，2011
The purpose of this study was to improve the pathogen detection in prosthetic joint infections, particularly to evaluate the feasibility of the sonication culture method in the clinical routine. Explanted components of all patients with presumptive prosthetic or implant infection were sonicated separately in sterile containers to dislodge the adherent bacteria from the surfaces and cultured. The results of sonication culture were compared to the conventional tissue culture. We investigated 60 consecutive patients with loosening of the prostheses or implants Forty patients had septic and 20 aseptic loosening (24 knee prostheses, 21 hip prostheses, 6 mega-prostheses, 2 shoulder prostheses, 6 osteosynthesis, 1 spinal instrumentation). The sensitivity of sonication fluid culture was 83.3%, of single positive tissue culture was 72.2% and 61.1% when two or more cultures yielded the same microorganism. In patients receiving antibiotic therapy the sensitivity was 65.9%, 57.5%, and 42.5%, respectively. Pathogens detected in a single tissue culture as well as in sonication culture yielded a significantly higher rate of prosthetic infection than conventional tissue culture alone (p = 0.008), even in patients receiving continuous antibiotic therapy before explantation (p = 0.016). The sonication method represents an essential add-on in pathogen detection compared to conventional tissue culture. (C) 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:617-622, 2011