Department of Orthopaedic, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin, Berlin, Germany.
J Orthop Res. 2013 Dec;31(12):2021-4. doi: 10.1002/jor.22451. Epub 2013 Jul 26.
The microbiological culture of sonicate fluid (SFC) of explanted endoprosthetic components has increased the rate of bacterial isolation in comparison to conventional microbiological methods. However, this creates the problem of interpreting cases of singular bacterial isolation through SFC, while all other microbiological samples remain negative. The aim of this study was to reference these singular positive SFC against, the histological classification of the periprosthetic membrane (PM), and the utilization of multiple SFC (separate sonication of individual endoprosthetic components). In this prospective study we compared the effect of multiple SFC for detection of periprosthetic joint infection (PJI) in patients with total hip revision surgery. All microbiological results were referenced against PM. Of the 102 cases there were 37 cases of PJI. Single SFC achieved the highest sensitivity of all individual parameters with 89% and a specificity of 72%. When multiple SFC were employed the sensitivity and specificity increased to 100%. There was a concordance of 86% between the PM and SFC. SFC achieved the highest sensitivity and it was possible to further improve the sensitivity and specificity when using multiple cultures. Multiple SFC and PM are beneficial to help reference singular bacterial isolations and achieve the diagnosis of PJI.
超声液（SFC）的微生物培养物与传统的微生物方法相比，提高了细菌分离的速度。然而，这就产生了通过 SFC 分离出单一细菌的情况的解释问题，而所有其他微生物样本均为阴性。本研究的目的是将这些 SFC 中单一的阳性样本与假体周围膜（PM）的组织学分类进行参考，并使用多个 SFC（单独对单个假体组件进行超声处理）。在这项前瞻性研究中，我们比较了在全髋关节翻修手术中，使用多个 SFC 检测假体周围关节感染（PJI）的效果。所有微生物学结果均与 PM 进行了参考。在 102 例中，有 37 例为 PJI。与所有单个参数相比，单个 SFC 的灵敏度最高，为 89%，特异性为 72%。当使用多个 SFC 时，灵敏度和特异性提高到 100%。PM 和 SFC 之间的一致性为 86%。SFC 的灵敏度最高，并且当使用多个培养物时，灵敏度和特异性可以进一步提高。多个 SFC 和 PM 有助于帮助参考单一细菌分离并实现 PJI 的诊断。
