TY - JOUR
T1 - Is an isolated positive sonication fluid culture in revision arthroplasties clinically relevant?
AU - ESCMID Study Group on Implant Associated Infections (ESGIAI)
AU - Rondaan, Christien
AU - Maso, Alessandra
AU - Birlutiu, Rares Mircea
AU - Fernandez Sampedro, Marta
AU - Soriano, Alex
AU - Diaz de Brito, Vicens
AU - Gómez Junyent, Joan
AU - Del Toro, Maria Dolores
AU - Hofstaetter, Jochen Gerhard
AU - Salles, Mauro José
AU - Esteban, Jaime
AU - Wouthuyzen-Bakker, Marjan
AU - Frank, Bernhard J.H.
AU - Auñon, Alvaro
AU - Morata, Laura
AU - Birlutiu, Victoria
AU - Storni, Elisa
AU - Sorli, Luisa
AU - Horcajada, Juan Pablo
AU - Hamburger, Flávio Guinsburg
AU - Salas Venero, Carlos
AU - Pietro, Cimatti
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/11
Y1 - 2023/11
N2 - 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.
AB - 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.
KW - Culture
KW - EBJIS
KW - Periprosthetic joint infection
KW - Single positive culture
KW - Sonication
UR - http://www.scopus.com/inward/record.url?scp=85168514656&partnerID=8YFLogxK
U2 - 10.1016/j.cmi.2023.07.018
DO - 10.1016/j.cmi.2023.07.018
M3 - Article
C2 - 37516385
AN - SCOPUS:85168514656
SN - 1198-743X
VL - 29
SP - 1431
EP - 1436
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 11
ER -