Implant surface culture may be a useful adjunct to standard tissue sampling culture for identification of pathogens accounting for fracture-device-related infection: a within-person randomized agreement study of 42 patients
Implant surface culture may be a useful adjunct to standard tissue sampling culture for identification of pathogens accounting for fracture-device-related infection: a within-person randomized agreement study of 42 patients
Background and purpose: identification of pathogens causing fracture-device-related infection (FDRI) is always a challenge as the positive rate of standard tissue sampling culture (TSC) remains unsatisfactory. This study evaluates the efficiency of implant surface culture (ISC) as an adjunct to standard TSC for identification of FDRI-associated microorganisms.
Patients and methods: between November 2020 and March 2022, patients diagnosed with FDRI defined by the International Fracture-Related Infection (FRI) Consensus Group, and indicated for implant removal, underwent both methods for bacteria detection. The test order of ISC and TSC was randomly selected for each patient included, as a within-person randomized design. For ISC, the recovered implants were gently covered with tryptic soy agar after rinsing with normal saline twice, and then incubated at 37℃ 5% CO2 for up to 14 days. For TSC, 5 specimens were sampled and sent to the Clinical Laboratory of Southern Medical University Nanfang Hospital, Guangzhou, for culture and identification.
Results: 42 consecutive patients were included, with a mean age of 46 years. The most frequent infection site and implant type were the tibia (21 cases) and plates with screws (30 cases), respectively. Altogether 21 patients were found with positive outcomes by both methods, and the identified pathogens were consistent. ISC found an additional 15 patients showing positive results, which were negative by TSC. Furthermore, the mean culture time of ISC was shorter than that of TSC (1.5 days vs. 3.2 days).
Interpretation: ISC may be a useful adjunct to TSC for detection of bacteria causing FDRI, with a relatively higher positive rate and a shorter culture time.
703-708
Jiang, Nan
a630c58c-69d0-4e6f-aec1-ed34f34891fa
Hu, Yan-Jun
2005adaf-a1d5-44fc-abcc-9843da06608b
Lin, Qing-rong
a2d5643b-7416-4615-806d-b12339f11d86
Chen, Peng
dff3fbc8-ecb7-4745-8bb4-c59fa4fc68bf
Wan, Hao-Yang
7acd3b2b-9e73-4bd2-8fd8-599c2404d42e
He, Si-Ying
233055e1-add5-4edd-b275-489306ef6cad
Stoodley, Paul
08614665-92a9-4466-806e-20c6daeb483f
Yu, Bin
6c573b34-2236-40db-bf38-312aeb293d55
7 September 2022
Jiang, Nan
a630c58c-69d0-4e6f-aec1-ed34f34891fa
Hu, Yan-Jun
2005adaf-a1d5-44fc-abcc-9843da06608b
Lin, Qing-rong
a2d5643b-7416-4615-806d-b12339f11d86
Chen, Peng
dff3fbc8-ecb7-4745-8bb4-c59fa4fc68bf
Wan, Hao-Yang
7acd3b2b-9e73-4bd2-8fd8-599c2404d42e
He, Si-Ying
233055e1-add5-4edd-b275-489306ef6cad
Stoodley, Paul
08614665-92a9-4466-806e-20c6daeb483f
Yu, Bin
6c573b34-2236-40db-bf38-312aeb293d55
Jiang, Nan, Hu, Yan-Jun, Lin, Qing-rong, Chen, Peng, Wan, Hao-Yang, He, Si-Ying, Stoodley, Paul and Yu, Bin
(2022)
Implant surface culture may be a useful adjunct to standard tissue sampling culture for identification of pathogens accounting for fracture-device-related infection: a within-person randomized agreement study of 42 patients.
Acta Orthopaedica, 93, .
(doi:10.2340/17453674.2022.4530).
Abstract
Background and purpose: identification of pathogens causing fracture-device-related infection (FDRI) is always a challenge as the positive rate of standard tissue sampling culture (TSC) remains unsatisfactory. This study evaluates the efficiency of implant surface culture (ISC) as an adjunct to standard TSC for identification of FDRI-associated microorganisms.
Patients and methods: between November 2020 and March 2022, patients diagnosed with FDRI defined by the International Fracture-Related Infection (FRI) Consensus Group, and indicated for implant removal, underwent both methods for bacteria detection. The test order of ISC and TSC was randomly selected for each patient included, as a within-person randomized design. For ISC, the recovered implants were gently covered with tryptic soy agar after rinsing with normal saline twice, and then incubated at 37℃ 5% CO2 for up to 14 days. For TSC, 5 specimens were sampled and sent to the Clinical Laboratory of Southern Medical University Nanfang Hospital, Guangzhou, for culture and identification.
Results: 42 consecutive patients were included, with a mean age of 46 years. The most frequent infection site and implant type were the tibia (21 cases) and plates with screws (30 cases), respectively. Altogether 21 patients were found with positive outcomes by both methods, and the identified pathogens were consistent. ISC found an additional 15 patients showing positive results, which were negative by TSC. Furthermore, the mean culture time of ISC was shorter than that of TSC (1.5 days vs. 3.2 days).
Interpretation: ISC may be a useful adjunct to TSC for detection of bacteria causing FDRI, with a relatively higher positive rate and a shorter culture time.
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Accepted/In Press date: 28 July 2022
e-pub ahead of print date: 7 September 2022
Published date: 7 September 2022
Additional Information:
Funding Information:
All patients signed the informed consent form, and this study was approved by the Medical Ethical Committee of the Southern Medical University Nanfang Hospital (NFEC-2020-075). Primary outcomes of the included patients are listed in Table 1; additional anonymized data can be shared on reasonable request. Research was funded by grants from NIH R01 (grant number: GM124436), National Natural Science Foundation of China (grant number: 82172197), and Guangdong Basic and Applied Basic Research Foundation (grant number: 2022A1515012385). There is no conflict of interest to declare.
Funding Information:
The authors are grateful for funding support from NIH R01, National Natural Science Foundation of China, and Guangdong Basic and Applied Basic Research Foundation. They would also like to thank the working staff, Dr Jing Chen from the Department of Clinical Laboratory of Southern Medical University Nanfang Hospital, for her help in pathogen identification.Acta thanks Martin Buttaro and Charles Vogely for help with peer review of this study.
Funding Information:
The authors are grateful for funding support from NIH R01, National Natural Science Foundation of China, and Guangdong Basic and Applied Basic Research Foundation. They would also like to thank the working staff, Dr Jing Chen from the Department of Clinical Laboratory of Southern Medical University Nanfang Hospital, for her help in pathogen identification.
Publisher Copyright:
© 2022 The Author(s).
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Local EPrints ID: 470482
URI: http://eprints.soton.ac.uk/id/eprint/470482
ISSN: 1745-3674
PURE UUID: 3245fa92-3704-4399-959c-1d860f3a622f
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Date deposited: 11 Oct 2022 16:50
Last modified: 05 Jun 2024 18:21
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Author:
Nan Jiang
Author:
Yan-Jun Hu
Author:
Qing-rong Lin
Author:
Peng Chen
Author:
Hao-Yang Wan
Author:
Si-Ying He
Author:
Bin Yu
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