Bacteriology
Time to positivity of acute and chronic periprosthetic joint infection cultures

https://doi.org/10.1016/j.diagmicrobio.2020.115178Get rights and content
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Highlights

  • Time to positivity is shorter for acute prosthetic joint infection cultures.

  • Prolonged empiric therapy is unnecessary in acute prosthetic joint infection.

  • Sonication has less benefit in acute prosthetic joint infection cultures.

  • Acute and chronic prosthetic joint infections are different laboratory entities.

Abstract

Introduction

A prolonged incubation time is generally recommended for diagnosing periprosthetic joint infections (PJI). However, in literature, no distinction is made between acute and chronic infections.

Methods

All patients with a PJI that underwent surgical debridement between November 2015 and February 2019 with or without revision of the prosthesis were retrospectively evaluated. Synovial fluid, 5 intraoperative periprosthetic tissue samples, and the sonicated prosthesis were cultured.

Results

Fifty-nine patients were analyzed, including 21 acute PJIs (33 isolates) and 38 chronic PJIs (46 isolates). In acute PJIs, all isolates grew within 5 days, while this took 11 days for chronic PJIs. Sonication fluid showed the shortest time to positivity (78% at day 2) for chronic PJIs, but no difference was observed for acute PJIs compared to tissue cultures.

Conclusion

In contrast to cultures from chronic PJIs, acute PJIs do not need a prolonged incubation time and no clear benefit is observed for sonication.

Keywords

Periprosthetic joint infection
Diagnosis
Acute
Chronic
Time to positivity
Sonication

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Declarations of interest: None.