Sonication as a Diagnostic Approach Used to Investigate the Infectious Etiology of Prosthetic Hip Joint Loosening
Agnieszka Bogut, Justyna Niedźwiadek, Maria Kozioł-Montewka, Dagmara Strzelec-Nowak, Jan Blacha, Tomasz Mazurkiewicz, Julia Macias, Wojciech Marczyński Pol J Microbiol 2014; 63 (3): ICID: 1122688 Article type: Original article IC™ Value: 10.00
Abstract provided by Publisher
The purpose of the study was to evaluate the usefulness of sonication for the diagnosis of prosthetic joint infections (PJIs) by its comparison with periprosthetic tissues (PTs) and synovial fluid (SV-F) cultures. The study groups included 56 patients undergoing exchange of total hip prostheses for so called “aseptic” loosening occurring without clinical manifestations of an accompanying PJI and 23 patients who developed a sinus tract communicating with the prosthesis which was indicative of an ongoing infectious process. Significant positive culture results were obtained among 12 (21%) patients with “aseptic” implant failure and in 19 (82%) patients who developed a sinus tract. Sonicate-fluid (S-F) yielded bacterial growth in all culture-positive patients with “aseptic” loosening vs. 15 patients with presumed PJIs. There was a concordance in terms of bacterial species isolated from S-F and conventional cultures from individual patients. Coagulase-negative staphylococci were isolated most frequently. Sensitivity of sonication (77.7%) exceeded that estimated for PTs (69.4%) and SV-F (46.1%) cultures. We conclude that identification of causative agents of PJIs which is critical to further therapeutic decisions is aided by the combination of sonication and conventional culture.