Is an isolated positive sonication fluid culture in revision arthroplasties clinically relevant?

ESCMID Study Group on Implant Associated Infections (ESGIAI), Christien Rondaan, Alessandra Maso, Rares Mircea Birlutiu, Marta Fernandez Sampedro, Alex Soriano, Vicens Diaz de Brito, Joan Gómez Junyent, Maria Dolores Del Toro, Jochen Gerhard Hofstaetter, Mauro José Salles, Jaime Esteban, Marjan Wouthuyzen-Bakker*, Juan Pablo Horcajada, Flávio Guinsburg Hamburger, Carlos Salas Venero, Cimatti Pietro

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    9 Citations (Scopus)
    47 Downloads (Pure)

    Abstract

    Objectives: The aim of this study was to investigate the clinical relevance of an isolated positive sonication fluid culture (SFC) in patients who underwent revision surgery of a prosthetic joint. We hypothesized that cases with a positive SFC have a higher rate of infection during follow-up compared with controls with a negative SFC.

    Methods: This retrospective multicentre observational study was performed within the European Study Group of Implant-Associated Infections. All patients who underwent revision surgery of a prosthetic joint between 2013 and 2019 and had a minimum follow-up of 1 year were included. Patients with positive tissue cultures or synovial fluid cultures were excluded from the study.

    Results: A total of 95 cases (positive SFC) and 201 controls (negative SFC) were included. Infection during follow-up occurred in 12 of 95 cases (12.6%) versus 14 of 201 controls (7.0%) (p = 0.125). In all, 79.8% of cases were with treated with antibiotics (76/95). Of the non-treated cases, 89% (17/19) had a positive SFC with a low virulent microorganism. When solely analysing patients who were not treated with antibiotics, 16% of the cases (3/19) had an infection during follow-up versus 5% of the controls (9/173) (p = 0.08).

    Discussion: Although not statistically significant, infections were almost twice as frequent in patients with an isolated positive SFC. These findings require further exploration in larger trials and to conclude about the potential benefit of antibiotic treatment in these cases.

    Original languageEnglish
    Pages (from-to)1431-1436
    Number of pages6
    JournalClinical Microbiology and Infection
    Volume29
    Issue number11
    DOIs
    Publication statusPublished - Nov-2023

    Keywords

    • Culture
    • EBJIS
    • Periprosthetic joint infection
    • Single positive culture
    • Sonication

    Fingerprint

    Dive into the research topics of 'Is an isolated positive sonication fluid culture in revision arthroplasties clinically relevant?'. Together they form a unique fingerprint.

    Cite this