Increased Detection of Polymicrobial Infections by Sonication and Significance of Prosthesis Design and Fixation Technique in Cases of Low-Grade PJI, a Retrospective Study  

作　　者：Nils Haustedt Jorge Armando González Chapa Moritz Hentschke Adrian Geovanni Rosas Taraco Nils Haustedt;Jorge Armando González Chapa;Moritz Hentschke;Adrian Geovanni Rosas Taraco(Clinic of Septic Bone and Soft-Tissue Surgery, Schön-Klinik Hamburg Eilbek, Hamburg, Germany;Departamento de Inmunologia, Facultad de Medicina, UANL, Monterrey, Mexico;Departement of Microbiology and Virology, Labor Fenner, Hamburg, Germany)

机构地区：[1]Clinic of Septic Bone and Soft-Tissue Surgery, Schö n-Klinik Hamburg Eilbek, Hamburg, Germany [2]Departamento de Inmunologia, Facultad de Medicina, UANL, Monterrey, Mexico [3]Departement of Microbiology and Virology, Labor Fenner, Hamburg, Germany

出　　处：《Open Journal of Orthopedics》2020年第10期269-288,共20页矫形学期刊（英文）

摘　　要：<b style="line-height:1.5;"><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:'';font-size:10pt;"><span style="font-family:Verdana;font-size:12px;"> Low-grade PJI remains a diagnostic dilemma in the medical community. It is mainly caused by low-virulent bacteria that cause chronic infection. This is mainly due to the formation of biofilms on the implant surface. This biofilm formation poses a diagnostic challenge that causes difficulties in the microbiological diagnosis of the infection by conventional culture methods. Sonication culture of implants has proven to be useful for biofilm forming bacteria. Therefore, we examined the evaluation of low-grade PJI using sonication culture methods and searched for influencing factors. </span><b><span style="font-family:Verdana;font-size:12px;">The methods:</span></b><span style="font-family:Verdana;font-size:12px;"> Between October 2016 and November 2019 we retrospectively examined adult patients with suggestive clinical and laboratory findings of low-grade PJI. The patient's medical history, demographic information, prosthesis type, laboratory findings and length of hospital stay were collected. The results of the microbiological culture were divided into the results of the conventional preoperative and intraoperative culture method and the results of the sonication. In addition, laboratory chemical diagnostics of the joint punctures and CRP determination were performed. Additionally, the influence of prosthesis design and fixation technique, with and without cement, was investigated. </span><b><span style="font-family:Verdana;font-size:12px;">The Results:</span></b><span style="font-family:Verdana;font-size:12px;"> Fifty-two patients with a mean age of 70.5 years were included in this study. The female population was more frequently affected. The most frequently affected joints were hip and knee. A higher percentage of pathogen detection was found at sonication with 60% of positive cultures, compared to 52% of intraoperative </span></sp<b style="line-height:1.5;"><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:'';font-size:10pt;"><span style="font-family:Verdana;font-size:12px;"> Low-grade PJI remains a diagnostic dilemma in the medical community. It is mainly caused by low-virulent bacteria that cause chronic infection. This is mainly due to the formation of biofilms on the implant surface. This biofilm formation poses a diagnostic challenge that causes difficulties in the microbiological diagnosis of the infection by conventional culture methods. Sonication culture of implants has proven to be useful for biofilm forming bacteria. Therefore, we examined the evaluation of low-grade PJI using sonication culture methods and searched for influencing factors. </span><b><span style="font-family:Verdana;font-size:12px;">The methods:</span></b><span style="font-family:Verdana;font-size:12px;"> Between October 2016 and November 2019 we retrospectively examined adult patients with suggestive clinical and laboratory findings of low-grade PJI. The patient's medical history, demographic information, prosthesis type, laboratory findings and length of hospital stay were collected. The results of the microbiological culture were divided into the results of the conventional preoperative and intraoperative culture method and the results of the sonication. In addition, laboratory chemical diagnostics of the joint punctures and CRP determination were performed. Additionally, the influence of prosthesis design and fixation technique, with and without cement, was investigated. </span><b><span style="font-family:Verdana;font-size:12px;">The Results:</span></b><span style="font-family:Verdana;font-size:12px;"> Fifty-two patients with a mean age of 70.5 years were included in this study. The female population was more frequently affected. The most frequently affected joints were hip and knee. A higher percentage of pathogen detection was found at sonication with 60% of positive cultures, compared to 52% of intraoperative </span></sp

关 键 词：PJI Low Grade Infections BIOFILM Sonication 

分 类 号：R68[医药卫生—骨科学]