Sonication: a valuable technique for diagnosis and treatment of periprosthetic joint infections

ScientificWorldJournal. 2013 Oct 10:2013:375140. doi: 10.1155/2013/375140. eCollection 2013.

Abstract

Background: Periprosthetic joint infection (PJI) is the most severe complication, following joint arthroplasty. Identification of the causal microbial factor is of paramount importance for the successful treatment.

Purpose: The aim of this study is to compare the sonication fluid cultures derived from joint prosthetic components with the respective periprosthetic tissue cultures.

Methods: Explanted prosthesis components for suspected infection were placed into a tank containing sterile Ringer's solution and sonicated for 1 minute at 40 kHz. Sonication fluid cultures were examined for 10 days, and the number and identity of any colony morphology was recorded. In addition, periprosthetic tissue specimens (>5) were collected and cultured according to standard practice. The duration of antimicrobial interruption interval before culture sampling was recorded.

Results: Thirty-four patients composed the study group. Sonication fluid cultures were positive in 24 patients (70.5%). Sixteen of thirty four periprosthetic tissue cultures (47.1%) were considered positive, all revealing the same microbial species with the respective sonication fluid cultures: 3 tissue samples showed polymicrobial infection. All tissue cultures were also found positive by the sonication fluid culture.

Conclusions: Sonication fluid cultures represent a cheap, easy, accurate, and sensitive diagnostic modality demonstrating increased sensitivity compared to periprosthetic tissue cultures (70.5 versus 47.1%).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biofilms / radiation effects*
  • Candida albicans / pathogenicity
  • Candida albicans / physiology
  • Escherichia coli / pathogenicity
  • Escherichia coli / physiology
  • Female
  • Humans
  • Joint Prosthesis / adverse effects*
  • Joint Prosthesis / microbiology
  • Male
  • Middle Aged
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / therapy
  • Proteus / pathogenicity
  • Proteus / physiology
  • Pseudomonas / pathogenicity
  • Pseudomonas / physiology
  • Sonication / methods*
  • Staphylococcus / pathogenicity
  • Staphylococcus / physiology