Effectiveness of closed suction drainage tip culture in hip arthroplasty

Acta Orthop Traumatol Turc. 2016;50(1):16-21. doi: 10.3944/AOTT.2016.15.0022.

Abstract

Objective: The aim of the present study was to investigate the correlation between bacterial growth in closed suction drainage tip culture and periprosthetic joint infection (PJI).

Methods: Retrospective review included 256 patients who had undergone hip arthroplasty in which the closed suction drainage tip was cultured. Follow-up periods were longer than a year. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated in order to determine the significance of closed suction drainage tip culture in early diagnosis of infection. Patients with positive culture test were monitored to determine the effect of change in antibiotics on treatment of early infection.

Results: Eight of the 13 infections showed positive results from closed suction drainage tip culture. Eleven of the 243 non-infectious cases showed positive results after closed suction drainage tip culture (p<0.001). Sensitivity of closed suction drainage tip culture was 61.5%, with a specificity of 95.5%. Positive and negative predictive values were 42.1% and 97.9%, respectively. Systemic antibiotics were administered according to in vitro sensitivity of bacteria cultured from closed suction drainage tip in 13 of 19 positive culture cases. No statistically significant difference in infection risk was observed between the antibiotics group and the group to which antibiotics were not administered (p=0.51).

Conclusion: Closed suction drainage tip culture can aid in the early detection of infection.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / instrumentation
  • Arthroplasty, Replacement, Hip / methods
  • Bacteria / drug effects
  • Bacteria / isolation & purification
  • Female
  • Femoral Neck Fractures / diagnosis
  • Femoral Neck Fractures / surgery*
  • Hip Joint / diagnostic imaging
  • Hip Joint / surgery
  • Hip Prosthesis / adverse effects*
  • Humans
  • Male
  • Microbial Sensitivity Tests / methods
  • Osteoarthritis, Hip / diagnosis
  • Osteoarthritis, Hip / surgery*
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / epidemiology
  • Prosthesis-Related Infections* / diagnosis
  • Prosthesis-Related Infections* / drug therapy
  • Prosthesis-Related Infections* / epidemiology
  • Prosthesis-Related Infections* / microbiology
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Sensitivity and Specificity
  • Suction / methods*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents