TY - JOUR
TI - Combination of conventional culture, vial culture, and broad-range PCR of sonication fluid for the diagnosis of prosthetic joint infection
AU - Stylianakis, A.
AU - Schinas, G.
AU - Thomaidis, P.C.
AU - Papaparaskevas, J.
AU - Ziogas, D.C.
AU - Gamaletsou, M.N.
AU - Daikos, G.L.
AU - Pneumaticos, S.
AU - Sipsas, N.V.
JO - Diagnostic Microbiology and Infectious Disease
PY - 2018
VL - 92
TODO - 1
SP - 13-18
PB - HANLEY & BELFUS-ELSEVIER INC
SN - 0732-8893
TODO - 10.1016/j.diagmicrobio.2018.04.008
TODO - adult;  aged;  area under the curve;  Article;  aseptic failure;  cohort analysis;  controlled clinical trial;  controlled study;  conventional culture;  diagnostic value;  differential diagnosis;  female;  human;  human tissue;  major clinical study;  male;  microbiological examination;  periprosthetic joint infection;  periprosthetic tissue culture;  polymerase chain reaction;  postoperative complication;  predictive value;  priority journal;  prospective study;  receiver operating characteristic;  sensitivity and specificity;  sonification fluid;  tissue culture;  total knee arthroplasty;  very elderly;  vial culture;  arthropathy;  communicable disease;  diagnostic imaging;  hip replacement;  infection;  knee;  microbiology;  middle aged;  polymerase chain reaction;  procedures;  prostheses and orthoses;  ultrasound, Aged;  Aged, 80 and over;  Arthroplasty, Replacement, Hip;  Communicable Diseases;  Female;  Humans;  Joint Diseases;  Knee Joint;  Male;  Middle Aged;  Polymerase Chain Reaction;  Prospective Studies;  Prostheses and Implants;  Prosthesis-Related Infections;  Sensitivity and Specificity;  Sonication
TODO - We assessed the value of conventional culture, vial culture, and broad-range PCR of the sonication fluid (SF), individually or in combinations, for the diagnosis of prosthetic joint infection (PJI). We studied 114 consecutive patients (median age:72.5 years, males: 28.07%) undergoing removal of a total knee or hip prosthesis. By non-microbiologic criteria, 87 patients had aseptic failure, and 27 PJI. All patients had periprosthetic tissue culture, sonication of prosthesis, and study of SF by conventional and vial culture, and PCR. Compared to tissue culture, each test was significantly more sensitive and less specific. If only one test was positive, the sensitivity was 88.46% and specificity 64.29%. If all three SF tests were positive, sensitivity, and NPV were decreasing (34.6% and 80.23%), but specificity and PPV were increasing up to 98.57% and 90.9%, respectively, outperforming tissue culture. A triple negative test practically excluded PJI. © 2018 Elsevier Inc.
ER -