Bacteriology Swabs in Primary Total Knee Arthroplasty

Overview

Journal GMS Hyg Infect Control

Specialty Health Services

Date 2013 Aug 23

PMID 23967388

Citations 2

Authors

Maximilian Haenle

Andreas Podbielski

Martin Ellenrieder

Andreas Mundt

Helga Krentz

Wolfram Mittelmeier

Ralf Skripitz

Affiliations

Soon will be listed here.

Abstract

Objective: An early detection of possible periprosthetic infection may lead to an earlier and potentially less invasive treatment of infected total knee arthroplasty TKA). The purpose of the present study was to evaluate retrospectively our current, affordable clinical practice of intra-operative swab taking during primary TKA.

Methods: A total of 206 primary TKA were analysed retrospectively for intra-operative bacteriology swabs and subsequent periprosthetic infection. All bacteriology swabs were obtained in a standardized manner including a tissue sample. Data was statistically evaluated concerning standard descriptive statistics and using the chi-square test.

Results: Bacteria were identified in 43.4% with coagulase-negative staphylococci being the most frequently isolated pathogens (52.2%). Regarding the contingency tables and chi-squared tests, generally no association was found between positive intra-operative swabs and subsequent periprosthetic infection as well as all other parameters investigated (timing of the antibiotic prophylaxis and pre-operative laboratory results).

Conclusions: Bacteriology swabs during primary total knee arthroplasty are no adequate measure to predict subsequent periprosthetic infections, even if augmented with a tissue sample.

Citing Articles

INTRAOPERATIVE EVALUATION AND LEVEL OF CONTAMINATION DURING TOTAL KNEE ARTHROPLASTY.

Alomar A, Alfayez S, Binnasser A, Aljassir F Acta Ortop Bras. 2022; 30(spe1):e243232.

PMID: 35864825 PMC: 9270042. DOI: 10.1590/1413-785220223001e243232.

Intraoperative Bacterial Contamination and Activity of Different Antimicrobial Prophylaxis Regimens in Primary Knee and Hip Replacement.

Rivera A, Sanchez A, Luque S, Mur I, Puig L, Crusi X Antibiotics (Basel). 2020; 10(1).

PMID: 33375415 PMC: 7823842. DOI: 10.3390/antibiotics10010018.

References

Dietz F, Koontz F, FOUND E, Marsh J . The importance of positive bacterial cultures of specimens obtained during clean orthopaedic operations. J Bone Joint Surg Am. 1991; 73(8):1200-7. View

Bernard L, Sadowski C, Monin D, Stern R, Wyssa B, Rohner P . The value of bacterial culture during clean orthopedic surgery: a prospective study of 1,036 patients. Infect Control Hosp Epidemiol. 2004; 25(6):512-4. DOI: 10.1086/502431. View

Zimmerli W, Trampuz A, Ochsner P . Prosthetic-joint infections. N Engl J Med. 2004; 351(16):1645-54. DOI: 10.1056/NEJMra040181. View

Moussa F, Anglen J, Gehrke J, Christensen G, Simpson W . The significance of positive cultures from orthopedic fixation devices in the absence of clinical infection. Am J Orthop (Belle Mead NJ). 1997; 26(9):617-20. View

Ellenrieder M, Lenz R, Haenle M, Bader R, Mittelmeier W . Two-stage revision of implant-associated infections after total hip and knee arthroplasty. GMS Krankenhhyg Interdiszip. 2012; 6(1):Doc17. PMC: 3252662. DOI: 10.3205/dgkh000174. View

Dobbins J, Seligson D, Raff M . Bacterial colonization of orthopedic fixation devices in the absence of clinical infection. J Infect Dis. 1988; 158(1):203-5. DOI: 10.1093/infdis/158.1.203. View

Jamsen E, Huhtala H, Puolakka T, Moilanen T . Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases. J Bone Joint Surg Am. 2009; 91(1):38-47. DOI: 10.2106/JBJS.G.01686. View

Lindgren U, Elmros T, Holm S . Bacteria in hip surgery. A study of routine aerobic and anaerobic cultivation from skin and closed suction wound drains. Acta Orthop Scand. 1976; 47(3):320-3. DOI: 10.3109/17453677608991999. View

Perry J, Ballou D, Salyer J . Inhibitory properties of a swab transport device. J Clin Microbiol. 1997; 35(12):3367-8. PMC: 230193. DOI: 10.1128/jcm.35.12.3367-3368.1997. View

10.

Davis N, Curry A, Gambhir A, Panigrahi H, Walker C, Wilkins E . Intraoperative bacterial contamination in operations for joint replacement. J Bone Joint Surg Br. 1999; 81(5):886-9. DOI: 10.1302/0301-620x.81b5.9545. View

11.

Fink B, Schafer P, Frommelt L . [Logistic requirements and biopsy of periprosthetic infections: what should be taken into consideration?]. Orthopade. 2012; 41(1):15-9. DOI: 10.1007/s00132-011-1836-0. View

12.

Desai A, Ramankutty S, Board T, Raut V . Does intraarticular steroid infiltration increase the rate of infection in subsequent total knee replacements?. Knee. 2009; 16(4):262-4. DOI: 10.1016/j.knee.2008.12.002. View

13.

Levine B, Evans B . Use of blood culture vial specimens in intraoperative detection of infection. Clin Orthop Relat Res. 2001; (382):222-31. DOI: 10.1097/00003086-200101000-00030. View

14.

Perry J . Assessment of swab transport systems for aerobic and anaerobic organism recovery. J Clin Microbiol. 1997; 35(5):1269-71. PMC: 232745. DOI: 10.1128/jcm.35.5.1269-1271.1997. View

15.

Jamsen E, Varonen M, Huhtala H, Lehto M, Lumio J, Konttinen Y . Incidence of prosthetic joint infections after primary knee arthroplasty. J Arthroplasty. 2008; 25(1):87-92. DOI: 10.1016/j.arth.2008.10.013. View

16.

Van Horn K, Audette C, Tucker K, Sebeck D . Comparison of 3 swab transport systems for direct release and recovery of aerobic and anaerobic bacteria. Diagn Microbiol Infect Dis. 2008; 62(4):471-3. DOI: 10.1016/j.diagmicrobio.2008.08.004. View

17.

Haenle M, Skripitz C, Mittelmeier W, Skripitz R . Economic impact of infected total knee arthroplasty. ScientificWorldJournal. 2012; 2012:196515. PMC: 3349123. DOI: 10.1100/2012/196515. View

18.

Overgaard S, Thomsen N, Kulinski B, Mossing N . Closed suction drainage after hip arthroplasty. Prospective study of bacterial contamination in 81 cases. Acta Orthop Scand. 1993; 64(4):417-20. DOI: 10.3109/17453679308993657. View

19.

Stefansdottir A, Johansson D, Knutson K, Lidgren L, Robertsson O . Microbiology of the infected knee arthroplasty: report from the Swedish Knee Arthroplasty Register on 426 surgically revised cases. Scand J Infect Dis. 2009; 41(11-12):831-40. DOI: 10.3109/00365540903186207. View

20.

Lindahl J, Korkala O, Pammo H, Miettinen A . Bacterial contamination and closed suction drainage in open meniscectomy of the knee. Ann Chir Gynaecol. 1993; 82(1):51-4. View