Increased Detection of Polymicrobial Infections by Sonication and Significance of Prosthesis Design and Fixation Technique in Cases of Low-Grade PJI, a Retrospective Study

• 作者: Adrian Geovanni Rosas Taraco Jorge Armando González Chapa Moritz Hentschke Nils Haustedt
• 来源期刊: 矫形学期刊(英文)
• 学科: 医学
• 关键词: PJI Low Grade Infections BIOFILM Sonication
• 年，卷（期）: 2020,（10）
• 页码范围: 269-288
• 页数: 20页
• 分类号: R68

摘要

<b style="line-height:1.5;"><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:'';font-size:10pt;"><span style="font-family:Verdana;font-size:12px;"> Low-grade PJI remains a diagnostic dilemma in the medical community. It is mainly caused by low-virulent bacteria that cause chronic infection. This is mainly due to the formation of biofilms on the implant surface. This biofilm formation poses a diagnostic challenge that causes difficulties in the microbiological diagnosis of the infection by conventional culture methods. Sonication culture of implants has proven to be useful for biofilm forming bacteria. Therefore, we examined the evaluation of low-grade PJI using sonication culture methods and searched for influencing factors. </span><b><span style="font-family:Verdana;font-size:12px;">The methods:</span></b><span style="font-family:Verdana;font-size:12px;"> Between October 2016 and November 2019 we retrospectively examined adult patients with suggestive clinical and laboratory findings of low-grade PJI. The patient's medical history, demographic information, prosthesis type, laboratory findings and length of hospital stay were collected. The results of the microbiological culture were divided into the results of the conventional preoperative and intraoperative culture method and the results of the sonication. In addition, laboratory chemical diagnostics of the joint punctures and CRP determination were performed. Additionally, the influence of prosthesis design and fixation technique, with and without cement, was investigated. </span><b><span style="font-family:Verdana;font-size:12px;">The Results:</span></b><span style="font-family:Verdana;font-size:12px;"> Fifty-two patients with a mean age of 70.5 years were included in this study. The female population was more frequently affected. The most frequently affected joints were hip and knee. A higher percentage of pathogen detection was found at sonication with 60% of positive cultures, compared to 52% of intraoperative </span></sp