Prospective Comparison of Blood Culture Bottles and Conventional Swabs for Microbial Identification of Suspected Periprosthetic Joint Infection

Jeffrey A Geller; Katherine P MacCallum; Taylor S Murtaugh; David A Patrick Jr; Barthelemy Liabaud; Venkata K Jonna

doi:10.1016/j.arth.2016.02.014

Prospective Comparison of Blood Culture Bottles and Conventional Swabs for Microbial Identification of Suspected Periprosthetic Joint Infection

J Arthroplasty. 2016 Aug;31(8):1779-83. doi: 10.1016/j.arth.2016.02.014. Epub 2016 Feb 24.

Authors

Jeffrey A Geller¹, Katherine P MacCallum¹, Taylor S Murtaugh¹, David A Patrick Jr¹, Barthelemy Liabaud¹, Venkata K Jonna¹

Affiliation

¹ Department of Orthopaedic Surgery, Center for Hip and Knee Replacement, New York-Presbyterian at Columbia University Medical Center, New York, New York.

PMID: 27020677
DOI: 10.1016/j.arth.2016.02.014

Abstract

Background: Early, accurate detection of infection is vital to successful treatment of periprosthetic joint infection (PJI). Currently, no "gold standard" diagnostic testing exists. The goal of this prospective study was to compare the efficacy of a blood culture bottle system (BCBS) to commonly used culture swabs in confirming PJI in patients with high clinical suspicion.

Methods: Patients were selected for enrollment based on Musculoskeletal Infection Society guidelines for PJI. erythrocyte sedimentation rate and C-reactive protein were obtained before aspiration. Aspirated fluid was divided between BCBS, swab, and synovial fluid analysis. Forty-nine samples were analyzed.

Results: BCBS yielded 41 positive cultures vs 19 with swab (P < .0001), particularly with respect to Staphylococcus epidermidis. There were no false positive results in the BCBS group, using strict Musculoskeletal Infection Society guidelines.

Conclusion: BCBS increased identification of pathogens in lower extremity PJI, providing clinicians with a low-cost, broadly-applicable test.

Keywords: blood culture bottles; conventional culture; diagnostic tool; lower extremity arthroplasty; periprosthetic joint infection.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Arthritis, Infectious / diagnosis*
Arthritis, Infectious / microbiology*
Blood Culture / methods*
Blood Sedimentation
C-Reactive Protein / analysis
Female
Humans
Male
Middle Aged
Prospective Studies
Prosthesis-Related Infections / diagnosis*
Prosthesis-Related Infections / microbiology*
Synovial Fluid / chemistry
Synovial Fluid / microbiology*

Substances

C-Reactive Protein