Unit:
Τομέας ΚλινικοεργαστηριακόςLibrary of the School of Health Sciences
Dissertation committee:
Νικόλαος Β. Σύψας, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Πνευματικός Σπυρίδων, Καθηγητής, Ιατρική, ΕΚΠΑ
Σοφία Χατζηϊωάννου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Παπαπαρασκευάς Ιωσήφ, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Σαμάρκος Μιχαήλ, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Βλάμης Ιωάννης, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Τριανταφυλλόπουλος Ιωάννης, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Εξελιγμένη μέθοδος διάγνωσης περιπροθετικών λοιμώξεων μετά απο κατεργασία με υπερήχους του αφαιρεθέντος εμφυτεύματος,προς απομόνωση και ταυτοποίηση των παθογόνων μικροοργανισμών που αναπτύσσονται σε αυτό.
Translated title:
Improved methodology for diagnosis of the periprothetic joint infections after sonication of the removed implants implant,aiming to isolate the pathogenic microorganisms.
Summary:
Objectives: Culture of fluid obtained by sonication of explanted prostheses (SF) improved the microbiologic diagnosis of prosthetic joint infection (PJI). We hypothesised that combining culture of SF (SFC) with broad range PCR (SFPCR) and direct inoculation of SF into blood culture bottles (SFVC) would further improve its diagnostic accuracy.
Methods: All consecutive patients undergoing removal of a total knee or hip prosthesis for aseptic failure (AF) or PJI, had periprosthetic tissue culture (PPTC), sonication of the prosthesis, and study of the SF by SFC, SFPCR, and SFVC. For individual tests and their combinations, sensitivities, specificities, and predictive values (positive, PPV and negative, NPV) were calculated.
Results: We studied 114 patients (median age: 72.5 years, males: 28.07%). By non-microbiologic criteria, 87 patients had AF, and 27 PJI. Compared to PPTC, each SF test was significantly more sensitive and less specific than PPTC. If 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 PPTC. A triple negative test practically excluded PJI.
Conclusions: Concurrent analysis of SF by SFC, SFVC and SFPCR, increases its diagnostic value.
Main subject category:
Health Sciences
Keywords:
Sonication, Periprothetic joint infections, Broad range PCR, Diagnosis
Number of references:
113
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