Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 4/2014

01.04.2014 | Hip Arthroplasty

Comparison of bacterial results from conventional cultures of the periprosthetic membrane and the synovial or pseudocapsule during hip revision arthroplasty

verfasst von: E. Muñoz-Mahamud, A. Soriano, A. Combalia, C. Medrano, J. Bosch, S. García, G. Bori

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 4/2014

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Bacterial identification is essential to diagnose and treat a revision for prosthetic loosening of an infected hip. The purpose of this study was to determine whether conventional cultures from the periprosthetic membrane are superior to synovial/pseudocapsule samples in the diagnosis of infection in hip revision arthroplasty.

Materials and methods

We performed a prospective study including all hip revisions from October 2009 to October of 2011. Once the implants were removed and prior to the administration of the antibiotic prophylaxis, six periprosthetic samples from different sites were sent to the laboratory for culturing: two periprosthetic fluid samples, two solid material (synovial/pseudocapsule) samples and two swabs. Once the six samples were taken, antibiotic prophylaxis was administered and just as the implant was removed, two more solid samples of the periprosthetic membrane were obtained.

Results

Of a total of 86 hip revision surgeries, 22 were considered septic revisions postoperatively, of which 16 resulted in positive cultures. Of these 16 revisions, 14 obtained the same microbiologic diagnostic when considering either the synovial/pseudocapsule culture results or the solid membrane sample.

Conclusions

We conclude that the membrane sample for a conventional culture is not superior to the synovial/pseudocapsule sample in detecting microorganisms.
Literatur
1.
Zurück zum Zitat Levine BR, Evans BG (2001) Use of blood culture vial specimens in intraoperative detection of infection. Clin Orthop Relat Res 382:222–231PubMedCrossRef Levine BR, Evans BG (2001) Use of blood culture vial specimens in intraoperative detection of infection. Clin Orthop Relat Res 382:222–231PubMedCrossRef
2.
Zurück zum Zitat Gómez-Barrena E, Esteban J, Medel F, Molina-Manso D, Ortiz-Pérez A, Cordero-Ampuero J, Puértolas JA (2012) Bacterial adherence to separated modular components in joint prosthesis: a clinical study. J Orthop Res 30(10):1634–1639PubMedCrossRef Gómez-Barrena E, Esteban J, Medel F, Molina-Manso D, Ortiz-Pérez A, Cordero-Ampuero J, Puértolas JA (2012) Bacterial adherence to separated modular components in joint prosthesis: a clinical study. J Orthop Res 30(10):1634–1639PubMedCrossRef
3.
Zurück zum Zitat Font-Vizcarra L, Garcia S, Martínez-Pastor JC, Sierra JM, Soriano A (2010) Blood culture flasks for culturing synovial fluid in prosthetic joint infections. Clin Orthop Relat Res 468(8):2238–2243PubMedCentralPubMedCrossRef Font-Vizcarra L, Garcia S, Martínez-Pastor JC, Sierra JM, Soriano A (2010) Blood culture flasks for culturing synovial fluid in prosthetic joint infections. Clin Orthop Relat Res 468(8):2238–2243PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Romanò C (2013) Antibiofilm agents and implant-related infections in orthopaedics: where are we? J Chemother 25(2):67–80PubMedCrossRef Romanò C (2013) Antibiofilm agents and implant-related infections in orthopaedics: where are we? J Chemother 25(2):67–80PubMedCrossRef
5.
Zurück zum Zitat Arciola CR, Montanaro L, Costerton JW (2011) New trends in diagnosis and control strategies for implant infections. Int J Artif Organs 34:727–736PubMedCrossRef Arciola CR, Montanaro L, Costerton JW (2011) New trends in diagnosis and control strategies for implant infections. Int J Artif Organs 34:727–736PubMedCrossRef
6.
Zurück zum Zitat Costerton JW, Stewart PS, Greenberg EP (1999) Bacterial biofilms: a common cause of persistent infections. Science 284:1318–1322PubMedCrossRef Costerton JW, Stewart PS, Greenberg EP (1999) Bacterial biofilms: a common cause of persistent infections. Science 284:1318–1322PubMedCrossRef
7.
Zurück zum Zitat Hill KE, Malic S, McKee R, Rennison T, Harding KG, Williams DW (2010) An in vitro model of chronic wound biofilms to test wound dressings and assess antimicrobial susceptibilities. J Antimicrob Chemother 65:1195–1206PubMedCrossRef Hill KE, Malic S, McKee R, Rennison T, Harding KG, Williams DW (2010) An in vitro model of chronic wound biofilms to test wound dressings and assess antimicrobial susceptibilities. J Antimicrob Chemother 65:1195–1206PubMedCrossRef
8.
Zurück zum Zitat Drago L, Romanò CL, Mattina R, Signori V, De Vecchi E (2012) Does dithiothreitol improve bacterial detection from infected prosthesis? A pilot study. Clin Orthop Relat Res 470(10):2915–2925PubMedCentralPubMedCrossRef Drago L, Romanò CL, Mattina R, Signori V, De Vecchi E (2012) Does dithiothreitol improve bacterial detection from infected prosthesis? A pilot study. Clin Orthop Relat Res 470(10):2915–2925PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Zameer F, Gopal S (2010) Evaluation of antibiotic susceptibility in mixed culture biofilms. Intern J Biotech Biochem 6:93–99 Zameer F, Gopal S (2010) Evaluation of antibiotic susceptibility in mixed culture biofilms. Intern J Biotech Biochem 6:93–99
10.
Zurück zum Zitat Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR (2013) Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the infectious diseases society of America. Clin Infect Dis 1(56):1–25CrossRef Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR (2013) Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the infectious diseases society of America. Clin Infect Dis 1(56):1–25CrossRef
11.
Zurück zum Zitat Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Valle Della CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG (2011) New definition for periprosthetic joint infection: from the workgroup of the musculoskeletal infection society. Clin Orthop Relat Res 469(11):2992–2994PubMedCentralPubMedCrossRef Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Valle Della CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG (2011) New definition for periprosthetic joint infection: from the workgroup of the musculoskeletal infection society. Clin Orthop Relat Res 469(11):2992–2994PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Bori G, Muñoz Mahamud E, Garcia S, Mallofre C, Gallart X, Bosch J, García E, Riba J, Mensa J, Soriano A (2011) Interface membrane is the best sample for histological study to diagnose prosthetic joint infection. Mod Pathol 24(4):579–584PubMedCrossRef Bori G, Muñoz Mahamud E, Garcia S, Mallofre C, Gallart X, Bosch J, García E, Riba J, Mensa J, Soriano A (2011) Interface membrane is the best sample for histological study to diagnose prosthetic joint infection. Mod Pathol 24(4):579–584PubMedCrossRef
13.
Zurück zum Zitat Bori G, Soriano A, Garcia S, Mallofre C, Riba J, Mensa J (2007) Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection. J Bone Jt Surg Am 89(6):1232–1237CrossRef Bori G, Soriano A, Garcia S, Mallofre C, Riba J, Mensa J (2007) Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection. J Bone Jt Surg Am 89(6):1232–1237CrossRef
14.
Zurück zum Zitat Atkins BL, Athanasou N, Deeks JJ, Crook DW, Simpson H, Peto TE, McLardy-Smith P, Berendt AR (1998) Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty. The OSIRIS collaborative study group. J Clin Microbiol 36(10):2932–2939PubMedCentralPubMed Atkins BL, Athanasou N, Deeks JJ, Crook DW, Simpson H, Peto TE, McLardy-Smith P, Berendt AR (1998) Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty. The OSIRIS collaborative study group. J Clin Microbiol 36(10):2932–2939PubMedCentralPubMed
15.
Zurück zum Zitat Trampuz A, Piper KE, Jacobson MJ, Hanssen AD, Unni KK, Osmon DR, Mandrekar JN, Cockerill FR, Steckelber JM, Greenleaf JF, Patel R (2007) Sonication of removed hip and knee prostheses for diagnosis of infection. N Engl J Med 357(7):654–663PubMedCrossRef Trampuz A, Piper KE, Jacobson MJ, Hanssen AD, Unni KK, Osmon DR, Mandrekar JN, Cockerill FR, Steckelber JM, Greenleaf JF, Patel R (2007) Sonication of removed hip and knee prostheses for diagnosis of infection. N Engl J Med 357(7):654–663PubMedCrossRef
16.
Zurück zum Zitat Pandey R, Berendt AR, Athanasou NA (2000) Histological and microbiological findings in non-infected and infected revision arthroplasty tissues. The OSIRIS collaborative study group. Oxford skeletal infection research and intervention service. Arch Orthop Trauma Surg 120(10):570–574PubMedCrossRef Pandey R, Berendt AR, Athanasou NA (2000) Histological and microbiological findings in non-infected and infected revision arthroplasty tissues. The OSIRIS collaborative study group. Oxford skeletal infection research and intervention service. Arch Orthop Trauma Surg 120(10):570–574PubMedCrossRef
17.
Zurück zum Zitat Mason JB, Fehring TK, Odum SM, Griffin WL, Nussman DS (2003) The value of white blood cell counts before revision total knee arthroplasty. J Arthroplast 18(8):1038–1043CrossRef Mason JB, Fehring TK, Odum SM, Griffin WL, Nussman DS (2003) The value of white blood cell counts before revision total knee arthroplasty. J Arthroplast 18(8):1038–1043CrossRef
18.
Zurück zum Zitat Mehra A, Hemmady MV, Nelson R, Hodgkinson JP (2006) Bacteriology swab in primary total hip arthroplasty: does it have a role? Int J Clin Pract 60(6):665–666PubMedCrossRef Mehra A, Hemmady MV, Nelson R, Hodgkinson JP (2006) Bacteriology swab in primary total hip arthroplasty: does it have a role? Int J Clin Pract 60(6):665–666PubMedCrossRef
19.
Zurück zum Zitat Burnett RSJ, Aggarwal A, Givens SA, McClure JT, Morgan PM, Barrack RL (2009) Prophylactic antibiotics do not affect cultures in the treatment of an infected TKA: a prospective trial. Clin Orthop Relat Res 468(1):127–134PubMedCentralPubMedCrossRef Burnett RSJ, Aggarwal A, Givens SA, McClure JT, Morgan PM, Barrack RL (2009) Prophylactic antibiotics do not affect cultures in the treatment of an infected TKA: a prospective trial. Clin Orthop Relat Res 468(1):127–134PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Tetreault MW, Wetters NG, Aggarwal V, Mont M, Parvizi J, Valle Della CJ (2013) The Chitranjan Ranawat Award: should prophylactic antibiotics be withheld before revision surgery to obtain appropriate cultures? Clin Orthop Relat Res 30. doi:10.1007/s11999-013-3016-5 (Epub ahead of print) Tetreault MW, Wetters NG, Aggarwal V, Mont M, Parvizi J, Valle Della CJ (2013) The Chitranjan Ranawat Award: should prophylactic antibiotics be withheld before revision surgery to obtain appropriate cultures? Clin Orthop Relat Res 30. doi:10.​1007/​s11999-013-3016-5 (Epub ahead of print)
21.
Zurück zum Zitat Panousis K, Grigoris P, Butcher I, Rana B, Reilly JH, Hamblen DL (2005) Poor predictive value of broad-range PCR for the detection of arthroplasty infection in 92 cases. Acta Orthop 76(3):341–346PubMed Panousis K, Grigoris P, Butcher I, Rana B, Reilly JH, Hamblen DL (2005) Poor predictive value of broad-range PCR for the detection of arthroplasty infection in 92 cases. Acta Orthop 76(3):341–346PubMed
22.
Zurück zum Zitat Spangehl MJ, Masri BA, O’Connell JX, Duncan CP (1999) Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Jt Surg Am 81(5):672–683 Spangehl MJ, Masri BA, O’Connell JX, Duncan CP (1999) Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Jt Surg Am 81(5):672–683
23.
Zurück zum Zitat Trampuz A, Zimmerli W (2005) Prosthetic joint infections: update in diagnosis and treatment. Swiss Med Wkly 24:1–10 Trampuz A, Zimmerli W (2005) Prosthetic joint infections: update in diagnosis and treatment. Swiss Med Wkly 24:1–10
24.
Zurück zum Zitat Steinberg JP, Braun BI, Hellinger WC, Kusek L, Bozikis MR, Bush AJ, Dellinger EP, Burke JP, Simmons B, Kritchevsky SB (2009) Timing of antimicrobial prophylaxis and the risk of surgical site infections: results from the trial to reduce antimicrobial prophylaxis errors. Ann Surg 250(1):10–16PubMedCrossRef Steinberg JP, Braun BI, Hellinger WC, Kusek L, Bozikis MR, Bush AJ, Dellinger EP, Burke JP, Simmons B, Kritchevsky SB (2009) Timing of antimicrobial prophylaxis and the risk of surgical site infections: results from the trial to reduce antimicrobial prophylaxis errors. Ann Surg 250(1):10–16PubMedCrossRef
25.
Zurück zum Zitat Stefánsdóttir A, Robertsson O, W-Dahl A, Kiernan S, Gustafson P, Lidgren L (2009) Inadequate timing of prophylactic antibiotics in orthopedic surgery. We can do better. Acta Orthop 80(6):633–638PubMedCentralPubMedCrossRef Stefánsdóttir A, Robertsson O, W-Dahl A, Kiernan S, Gustafson P, Lidgren L (2009) Inadequate timing of prophylactic antibiotics in orthopedic surgery. We can do better. Acta Orthop 80(6):633–638PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Suda A, Kommerell M, Geiss HK, Burckhardt I, Zimmermann S, Zeifang F, Lehner B (2013) Prosthetic infection: diagnostic procedures using 16S ribosomal deoxyribonucleic acid polymerase chain reaction. Int Orthop 37(12):2515–2521PubMedCrossRef Suda A, Kommerell M, Geiss HK, Burckhardt I, Zimmermann S, Zeifang F, Lehner B (2013) Prosthetic infection: diagnostic procedures using 16S ribosomal deoxyribonucleic acid polymerase chain reaction. Int Orthop 37(12):2515–2521PubMedCrossRef
27.
Zurück zum Zitat Esteban J, Alonso-Rodriguez N, del-Prado G, Ortiz-Pérez A, Molina-Manso D, Cordero-Ampuero J, Sandoval E, Fernández-Roblas R, Gómez-Barrena E (2012) PCR-hybridization after sonication improves diagnosis of implant-related infection. Acta Orthop 83:299–304PubMedCentralPubMedCrossRef Esteban J, Alonso-Rodriguez N, del-Prado G, Ortiz-Pérez A, Molina-Manso D, Cordero-Ampuero J, Sandoval E, Fernández-Roblas R, Gómez-Barrena E (2012) PCR-hybridization after sonication improves diagnosis of implant-related infection. Acta Orthop 83:299–304PubMedCentralPubMedCrossRef
28.
Zurück zum Zitat Greenwood-Quaintance KE, Uhl JR, Hanssen AD, Sampath R, Mandrekar JN, Patel R (2013) Diagnosis of prosthetic joint infection (PJI) using polymerase chain reaction-electrospray ionization mass spectrometry (PCR-ESI/MS). J Clin Microbiol. doi:10.1128/JCM.03217-13 PubMedCentral Greenwood-Quaintance KE, Uhl JR, Hanssen AD, Sampath R, Mandrekar JN, Patel R (2013) Diagnosis of prosthetic joint infection (PJI) using polymerase chain reaction-electrospray ionization mass spectrometry (PCR-ESI/MS). J Clin Microbiol. doi:10.​1128/​JCM.​03217-13 PubMedCentral
29.
Zurück zum Zitat Tunney MM, Patrick S, Curran MD, Ramage G, Hanna D, Nixon JR, Gorman SP, Davis RI, Anderson N (1999) Detection of prosthetic hip infection at revision arthroplasty by immunofluorescence microscopy and PCR amplification of the bacterial 16S rRNA gene. J Clin Microbiol 37(10):3281–3290PubMedCentralPubMed Tunney MM, Patrick S, Curran MD, Ramage G, Hanna D, Nixon JR, Gorman SP, Davis RI, Anderson N (1999) Detection of prosthetic hip infection at revision arthroplasty by immunofluorescence microscopy and PCR amplification of the bacterial 16S rRNA gene. J Clin Microbiol 37(10):3281–3290PubMedCentralPubMed
30.
Zurück zum Zitat Marin M, Garcia-Lechuz JM, Alonso P, Villanueva M, Alcala L, Gimeno M, Cercenado E, Sánchez-Somolinos M, Radice C, Bouza E (2012) Role of universal 16S rRNA gene PCR and sequencing in diagnosis of prosthetic joint infection. J Clin Microbiol 50(3):583–589PubMedCentralPubMedCrossRef Marin M, Garcia-Lechuz JM, Alonso P, Villanueva M, Alcala L, Gimeno M, Cercenado E, Sánchez-Somolinos M, Radice C, Bouza E (2012) Role of universal 16S rRNA gene PCR and sequencing in diagnosis of prosthetic joint infection. J Clin Microbiol 50(3):583–589PubMedCentralPubMedCrossRef
31.
Zurück zum Zitat Jacovides CL, Parvizi J, Adeli B, Jung KA (2011) Molecular markers for diagnosis of periprosthetic joint infection. J Arthroplast 26(6):99–103CrossRef Jacovides CL, Parvizi J, Adeli B, Jung KA (2011) Molecular markers for diagnosis of periprosthetic joint infection. J Arthroplast 26(6):99–103CrossRef
32.
Zurück zum Zitat Wetters NG, Berend KR, Lombardi AV, Morris MJ, Tucker TL, Valle Della CJ (2012) Leukocyte esterase reagent strips for the rapid diagnosis of periprosthetic joint infection. J Arthroplast 27(8):8–11CrossRef Wetters NG, Berend KR, Lombardi AV, Morris MJ, Tucker TL, Valle Della CJ (2012) Leukocyte esterase reagent strips for the rapid diagnosis of periprosthetic joint infection. J Arthroplast 27(8):8–11CrossRef
33.
Zurück zum Zitat Deirmengian C, Hallab N, Tarabishy A, Valle Della C, Jacobs JJ, Lonner J, Booth RE Jr (2010) Synovial fluid biomarkers for periprosthetic infection. Clin Orthop Relat Res 468(8):2017–2023PubMedCentralPubMedCrossRef Deirmengian C, Hallab N, Tarabishy A, Valle Della C, Jacobs JJ, Lonner J, Booth RE Jr (2010) Synovial fluid biomarkers for periprosthetic infection. Clin Orthop Relat Res 468(8):2017–2023PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Ahn JK, Huang B, Bae EK, Park EJ, Hwang JW, Lee J, Koh EM, Cha HS (2013) The role of α-defensin-1 and related signal transduction mechanisms in the production of IL-6, IL-8 and MMPs in rheumatoid fibroblast-like synoviocytes. Rheumatol (Oxford) 52(8):1368–1376CrossRef Ahn JK, Huang B, Bae EK, Park EJ, Hwang JW, Lee J, Koh EM, Cha HS (2013) The role of α-defensin-1 and related signal transduction mechanisms in the production of IL-6, IL-8 and MMPs in rheumatoid fibroblast-like synoviocytes. Rheumatol (Oxford) 52(8):1368–1376CrossRef
Metadaten
Titel
Comparison of bacterial results from conventional cultures of the periprosthetic membrane and the synovial or pseudocapsule during hip revision arthroplasty
verfasst von
E. Muñoz-Mahamud
A. Soriano
A. Combalia
C. Medrano
J. Bosch
S. García
G. Bori
Publikationsdatum
01.04.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 4/2014
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-014-1921-z

Weitere Artikel der Ausgabe 4/2014

Archives of Orthopaedic and Trauma Surgery 4/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.