Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700, RB, Groningen.
Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700, RB, Groningen.
Diagn Microbiol Infect Dis. 2021 Jan;99(1):115178. doi: 10.1016/j.diagmicrobio.2020.115178. Epub 2020 Aug 14.
A prolonged incubation time is generally recommended for diagnosing periprosthetic joint infections (PJI). However, in literature, no distinction is made between acute and chronic infections.
All patients with a PJI that underwent surgical debridement between November 2015 and February 2019 with or without revision of the prosthesis were retrospectively evaluated. Synovial fluid, 5 intraoperative periprosthetic tissue samples, and the sonicated prosthesis were cultured.
Fifty-nine patients were analyzed, including 21 acute PJIs (33 isolates) and 38 chronic PJIs (46 isolates). In acute PJIs, all isolates grew within 5 days, while this took 11 days for chronic PJIs. Sonication fluid showed the shortest time to positivity (78% at day 2) for chronic PJIs, but no difference was observed for acute PJIs compared to tissue cultures.
In contrast to cultures from chronic PJIs, acute PJIs do not need a prolonged incubation time and no clear benefit is observed for sonication.
一般建议延长孵育时间以诊断假体周围关节感染（PJI）。然而，文献中并未对急性和慢性感染进行区分。
回顾性分析了 2015 年 11 月至 2019 年 2 月期间行手术清创术且（或）行假体翻修的所有 PJI 患者。对关节滑液、5 份术中假体周围组织样本和超声处理后的假体进行了培养。
共分析了 59 例患者，包括 21 例急性 PJI（33 株分离菌）和 38 例慢性 PJI（46 株分离菌）。在急性 PJI 中，所有分离菌均在 5 天内生长，而慢性 PJI 则需要 11 天。对于慢性 PJI，超声处理后的液体显示出最短的阳性时间（第 2 天为 78%），但与组织培养相比，急性 PJI 没有差异。
与慢性 PJI 的培养物相比，急性 PJI 不需要延长孵育时间，且超声处理也没有明显获益。
