Microbiological Diagnosis of Prosthetic Joint Infections
PDF
Cite
Share
Request
REVIEW
P: 24-24
January 2021

Microbiological Diagnosis of Prosthetic Joint Infections

Mediterr J Infect Microb Antimicrob 2021;10(1):24-24
1. Hatay Mustafa Kemal University, Tayfur Ata Sökmen Faculty of Medicine, Department of Medical Microbiology, Hatay, Turkey
No information available.
No information available
PDF
Cite
Share
Request

Summary

Prosthetic joint infections (PJI) are the most important complication of joint replacement surgery. Diagnosis of PJI should be made with a multidisciplinary approach. Microbiological diagnostic methods must be used to isolate the causative microorganisms and to determine the antimicrobial susceptibility of these microorganisms. Microbiological methods used in preoperative diagnosis are blood culture, leukocyte count and type in synovial fluid and culture of synovial fluid. Those used in intraoperative diagnosis are cultures of abscesses, synovial fluid, soft tissue and bones located in and around prosthesis taken during the surgery. Other microbiological methods used in diagnosis of PJIs are microcalorimetry, matrix assisted lazer desorption/ionization-time of flight mass spectrometry, homogenization of tissue samples with glass beads, fluorescent in situ hybridization, synovial biomarkers, enzymatic template generation and amplification. Also, various molecular methods such as 16S rRNA sequencing analysis and polymerase chain reaction methods can be used for diagnosis of PJI. The aim of this review was to discuss the microbiological diagnostic methods of PJI in the light of current literatures.

Keywords:
Microbiology, prosthesis, joint infections, diagnosis

References

1
Tande AJ, Patela R. Prosthetic joint infection. Clin Microbiol Rev. 2014;27:302-45.
2
Esposito S, Leone S. Prosthetic joint infections: microbiology, diagnosis, management and prevention. Int J Antimicrob Agents. 2008;32:287-93.
3
Ersöz G. Orthopedic prosthetic infections. Klimik Dergisi. 2013;26:84-93.
4
Cataldo MA, Petrosillo N, Cipriani M, Cauda R, Tacconelli E. Prosthetic joint infection: Recent developments in diagnosis and management. J Infect. 2010;61:443-8.
5
Legout L, Senneville E. Periprosthetic joint infections: clinical and bench research. Scientific World Journal. 2013;2013:549091.
6
Diktaş H, Turhan V. Orthopedic prosthetic infections: current approaches to diagnosis, treatment and management. Mediterr J Infect Microb Antimicrob. 2012;1:12.
7
Miller JM, Binnicker MJ, Campbell S, Carroll KC, Chapin KC, Gilligan PH, Gonzalez MD, Jerris RC, Kehl SC, Patel R, Pritt BS, Richter SS, Robinson- Dunn B, Schwartzman JD, Snyder JW, Telford S, Theel ES, Thomson Jr RB, Weinstein MP, Yao JD. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018;67:e1-94.
8
Saeed K. Diagnostics in prosthetic joint infections. J Antimicrob Chemother 2014;69(Suppl 1): i1-i19.
9
Cassar Gheiti AJ, Mulhall J. Peri-prosthetic joint infection: prevention, diagnosis and management. In: Kinov P (ed). Arthroplasty update, Chapter: 22. London: Intechopen Publisher, 2013:481-515.
10
Kandemir Ö. Prosthetic joint infections. ANKEM Derg. 2014;28(Ek 2):18-26.
11
Toossi N, Adeli B, Rasouli MR, Huang R, Parvizi J. Serum white blood cell count and differential do not have a role in the diagnosis of periprosthetic joint infection. J Arthroplasty 2012; 27(Suppl 8):51-4.
12
Kalayoğlu Beşışık S. Erythrocyte sedimentation rate. Nobel Medicus. 2005;1:4-9.
13
Otto-Lambertz C, Yagdiran A, Wallscheid F, Eysel P, Jung N. Periprosthetic infection in joint replacement diagnosis and treatment. Dtsch Arztebl Int. 2017;114:347-53.
14
Ghanem E, Antoci V, Jr. Pulido L, Joshi A, Hozack W, Parvizi J. The use of receiver operating characteristics analysis in determining erythrocyte sedimentation rate and C-reactive protein levels in diagnosing periprosthetic infection prior to revision total hip arthroplasty. Int J Infect Dis. 2009;13:444-9.
15
Esposito S, Leone S. Prosthetic joint infections: microbiology, diagnosis, management and prevention. Int J Antimicrob Agents. 2008;32:287-93.
16
Moran E, Byren I, Atkins BL. The diagnosis and management of prosthetic joint infections. J Antimicrob Chemother. 2010;65(Suppl 3):iii45-54.
17
Piper KE, Fernandez-Sampedro M, Steckelberg KE, Mandrekar JN, Karau MJ, Steckelberg JM, Berbari EF, Osmon DR, Hanssen AD, Lewallen DG, Cofield RH, Sperling JW, Sanchez-Sotelo J, Huddleston PM, Dekutoski MB, Yaszemski M, Currier B, Patel R. C-Reactive protein, erythrocyte sedimentation rate and orthopedic implant infection. PLoS One. 2010;5:e9358.
18
National Center for Health Statistics. National Hospital Discharge Survey: 2004 annual summary with detailed diagnosis and procedure data. National Center for Health Statistics, 2009. Available from: https://www.cdc.gov/nchs/data/series/sr_13/sr13_162.pdf
19
Drago L, Clerici P, Morelli I, Ashok J, Benzakour T, Bozhkova S, Alizadeh C, Del Sel H, Sharma HK, Peel T, Mattina R, Romanò CL. The World Association against Infection in Orthopaedics and Trauma (WAIOT) procedures for Microbiological Sampling and Processing for Periprosthetic Joint Infections (PJIs) and other implant-related infections. J Clin Med. 2019;8:1-16.
20
Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR, Infectious Diseases Society of America. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2013;56:1-10.
21
Dalkılıç E, Gül C.B, Alkış N. Interleukin-6: One of the Leading Actors on Inflammation. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2012;38:157-60.
22
Di Cesare PE, Chang E, Preston CF, Liu CJ. Serum interleukin-6 as a marker of periprosthetic infection following total hip and knee arthroplasty. J Bone Joint Surg Am. 2005;87:1921-7.
23
Wirtz DC, Heller KD, Miltner O, Zilkens KW, Wolff JM. Interleukin-6: a potential inflammatory marker after total joint replacement. Int Orthop. 2000;24:194-6.
24
Marculescu CE, Cantey JR. Polymicrobial prosthetic joint infections risk factors and outcome. Clin Orthop Relat Res. 2008;466:1397-404.
25
Trampuz A, Steckelberg JM, Osmon DR, Cockerill FR, Hanssen AD, Patel R. Advances in the laboratory diagnosis of prosthetic joint infection. Rev Med Microbiol. 2003;14:1-14.
26
Hughes JG, Vetter EA, Patel R, C D Schleck, Harmsen S, Turgeant LT, Cockerill FR. Culture with BACTEC peds plus/f bottle compared with conventional methods for detection of bacteria in synovial fluid. J Clin Microbiol. 2001;39:4468-71.
27
Gül HC, Artuk C, Yıldız C. Diagnosis, treatment and management of prosthetic infections. J Clin Anal Med. 2013;4:332-9.
28
Tsukayama T, Goldberg VM, Kyle R. Diagnosis and Management of Infection After Total Knee Arthroplasty. J Bone Joint Surg. 2003;85-A(Suppl 1):75-80.
29
Evangelopoulos DS, Stathopoulos IP, Morassi GP, Koufos S, Albarni A, Karampinas PK, A Stylianakis, S Kohl, Pneumaticos S, Vlamis J. Sonication: a valuable technique for diagnosis and treatment of periprosthetic joint infections. Scientific World Journal. 2013;2013:375140.
30
Drago L, Signori V, De Vecchi E, Vassena C, Palazzi E, Cappelletti L, Romanò D, Romanò CL. Use of dithiothreitol to improve the diagnosis of prosthetic joint infections. J Orthop Res. 2013;31:1694-9.
31
Sambri A, Cadossi M, Giannini S, Pignatti G, Marcacci M, Neri MP, Maso A, Storni E, Gamberini S, Naldi S, Torri A, Zannoli S, Tassinari M, Fantini M, Bianchi G, Donati D, Sambri V. Is treatment with dithiothreitol more efective than sonication for the diagnosis of prosthetic joint infection? Clin Orthop Relat Res. 2018;476:137-45.
32
Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG. New definition for periprosthetic joint infection: from the workgroup of the musculoskeletal infection society. Clin Orthop Relat Res. 2011;469:2992-4.
33
Romano CL, Al Khawashki H, Benzakour T, Bozhkova S, Del Sel H, Hafez M, Johari A, Lob G, Sharma HK, Tsuchiya H, Drago L, World Association against Infection in Orthopedics and Trauma (W.A.I.O.T.) Study Group on Bone and Joint Infection Definitions. The W.A.I.O.T. Definition of High-Grade and Low-Grade Peri-Prosthetic Joint Infection. J Clin Med. 2019;8:650.
34
George DA, Drago L, Scarponi S, Gallazzi E, Haddad FS, Romano CL. Predicting lower limb periprosthetic joint infections: A review of risk factors and their classification. World J Orthop. 2017;8:400.
35
Buchan BW, Ledeboer NA. Emerging Technologies for the Clinical Microbiology Laboratory. Clin Microbiol Rev. 2014;27:783-822.
36
Wilcox MH. Overcoming barriers to effective recognition and diagnosis of Clostridium difficile infection. Clin Microbiol Infect. 2012;18(Suppl 6):13-20.
37
Deirmengian C, Hallab N, Tarabishy A, Della Valle C, Jacobs JJ, Lonner J, Booth RE Jr. Synovial fluid biomarkers for periprosthetic infection. Clin Orthop Relat Res. 2010;468:2017-23.