Culturing Periprosthetic Tissue in BacT/Alert® Virtuo Blood Culture System Leads to Improved and Faster Detection of Prosthetic Joint Infections

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2019 Jul 12

PMID 31291897

Citations 11

Authors

Adriana Sanabria

Merethe E O Rokeberg

Mona Johannessen

Johanna Ericson Sollid

Gunnar Skov Simonsen

Anne-Merethe Hanssen

Affiliations

Soon will be listed here.

Abstract

Background: Blood culture bottles (BCBs) provide a semiautomated method for culturing periprosthetic tissue specimens. A study evaluating BCBs for culturing clinical samples other than body fluids is needed before implementation into clinical practice. Our objective was to evaluate use of the BacT/Alert® Virtuo blood culture system for culturing periprosthetic tissue specimens.

Methods: The study was performed through the analysis of spiked (n = 36) and clinical (n = 158) periprosthetic tissue samples. Clinical samples were analyzed by the BCB method and the results were compared to the conventional microbiological culture-based method for time to detection and microorganisms identified.

Results: The BacT/Alert® Virtuo blood culture system detected relevant bacteria for prosthetic joint infection in both spiked and clinical samples. The BCB method was found to be as sensitive (79%) as the conventional method (76%) (p = 0.844) during the analyses of clinical samples. The BCB method yielded positive results much faster than the conventional method: 89% against 27% detection within 24 h, respectively. The median detection time was 11.1 h for the BCB method (12 h and 11 h for the aerobic and the anaerobic BCBs, correspondingly).

Conclusion: We recommend using the BacT/Alert® Virtuo blood culture system for analyzing prosthetic joint tissue, since this detect efficiently and more rapidly a wider range of bacteria than the conventional microbiological method.

Citing Articles

Prolonged incubation time unwarranted for acute periprosthetic joint infections.

Morreel E, van Dessel H, Geurts J, Savelkoul P, van Loo I J Clin Microbiol. 2025; 63(2):e0114324.

PMID: 39817758 PMC: 11837491. DOI: 10.1128/jcm.01143-24.

Rapid high-throughput processing of tissue samples for microbiological diagnosis of periprosthetic joint infections using bead-beating homogenization.

Jazmati N, Liebold C, Offerhaus C, Volkenand A, Grote S, Popsel J J Clin Microbiol. 2024; 62(4):e0148623.

PMID: 38415637 PMC: 11005376. DOI: 10.1128/jcm.01486-23.

Comparison of microbial detection rates in microbial culture methods versus next-generation sequencing in patients with prosthetic joint infection: a systematic review and meta-analysis.

Kato H, Hagihara M, Asai N, Umemura T, Hirai J, Yamagishi Y J Orthop Surg Res. 2023; 18(1):604.

PMID: 37587529 PMC: 10428596. DOI: 10.1186/s13018-023-03973-5.

Detection of Microorganisms in Clinical Sonicated Orthopedic Devices Using Conventional Culture and qPCR.

Ribeiro V, Cieslinski J, Bertol J, Schumacher A, Telles J, Tuon F Rev Bras Ortop (Sao Paulo). 2022; 57(4):689-696.

PMID: 35966434 PMC: 9365468. DOI: 10.1055/s-0041-1732386.

Shotgun-metagenomics based prediction of antibiotic resistance and virulence determinants in Staphylococcus aureus from periprosthetic tissue on blood culture bottles.

Sanabria A, Janice J, Hjerde E, Simonsen G, Hanssen A Sci Rep. 2021; 11(1):20848.

PMID: 34675288 PMC: 8531021. DOI: 10.1038/s41598-021-00383-7.

References

Hughes J, Vetter E, Patel R, Schleck C, Harmsen S, Turgeant L . Culture with BACTEC Peds Plus/F bottle compared with conventional methods for detection of bacteria in synovial fluid. J Clin Microbiol. 2001; 39(12):4468-71. PMC: 88567. DOI: 10.1128/JCM.39.12.4468-4471.2001. View

Carlos Lopez Bernaldo de Quiros J, Sanchez-Carrillo C, Cercenado E, Fron C, Catalan P, Bouza E . Clinical impact of a 5-day versus 7-day blood culture incubation period. Clin Microbiol Infect. 1996; 2(2):143-144. DOI: 10.1111/j.1469-0691.1996.tb00221.x. View

Raad J, Peacock Jr J . Septic arthritis in the adult caused by Streptococcus pneumoniae: a report of 4 cases and review of the literature. Semin Arthritis Rheum. 2004; 34(2):559-69. DOI: 10.1016/j.semarthrit.2004.04.002. View

Bertani A, Drouin C, Demortiere E, Gonzalez J, Candoni P, Di Schino M . [A prosthetic joint infection caused by Streptococcus pneumoniae: a case report and review of the literature]. Rev Chir Orthop Reparatrice Appar Mot. 2006; 92(6):610-4. DOI: 10.1016/s0035-1040(06)75921-9. View

Kurtz S, Ong K, Lau E, Mowat F, Halpern M . Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007; 89(4):780-5. DOI: 10.2106/JBJS.F.00222. View

Berbari E, Marculescu C, Sia I, Lahr B, Hanssen A, Steckelberg J . Culture-negative prosthetic joint infection. Clin Infect Dis. 2007; 45(9):1113-9. DOI: 10.1086/522184. View

Schafer P, Fink B, Sandow D, Margull A, Berger I, Frommelt L . Prolonged bacterial culture to identify late periprosthetic joint infection: a promising strategy. Clin Infect Dis. 2008; 47(11):1403-9. DOI: 10.1086/592973. View

Font-Vizcarra L, Garcia S, Martinez-Pastor J, Sierra J, Soriano A . Blood culture flasks for culturing synovial fluid in prosthetic joint infections. Clin Orthop Relat Res. 2010; 468(8):2238-43. PMC: 2895826. DOI: 10.1007/s11999-010-1254-3. View

Velay A, Schramm F, Gaudias J, Jaulhac B, Riegel P . Culture with BACTEC Peds Plus bottle compared with conventional media for the detection of bacteria in tissue samples from orthopedic surgery. Diagn Microbiol Infect Dis. 2010; 68(1):83-5. DOI: 10.1016/j.diagmicrobio.2010.04.010. View

10.

Butler-Wu S, Burns E, Pottinger P, Magaret A, Rakeman J, Matsen 3rd F . Optimization of periprosthetic culture for diagnosis of Propionibacterium acnes prosthetic joint infection. J Clin Microbiol. 2011; 49(7):2490-5. PMC: 3147880. DOI: 10.1128/JCM.00450-11. View

11.

Hughes H, Newnham R, Athanasou N, Atkins B, Bejon P, Bowler I . Microbiological diagnosis of prosthetic joint infections: a prospective evaluation of four bacterial culture media in the routine laboratory. Clin Microbiol Infect. 2011; 17(10):1528-30. DOI: 10.1111/j.1469-0691.2011.03597.x. View

12.

Parvizi J, Zmistowski B, Berbari E, Bauer T, Springer B, Della Valle C . New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res. 2011; 469(11):2992-4. PMC: 3183178. DOI: 10.1007/s11999-011-2102-9. View

13.

Dale H, Fenstad A, Hallan G, Havelin L, Furnes O, Overgaard S . Increasing risk of prosthetic joint infection after total hip arthroplasty. Acta Orthop. 2012; 83(5):449-58. PMC: 3488170. DOI: 10.3109/17453674.2012.733918. View

14.

Osmon D, Berbari E, Berendt A, Lew D, Zimmerli W, Steckelberg J . Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2012; 56(1):e1-e25. DOI: 10.1093/cid/cis803. View

15.

Nylen T, Saeedi B, Borg C, Ullberg M, Ozenci V . The performance of 4 different supplements and 5 blood culture bottles types in detection of bacteria and Candida spp. in simulated sterile body fluid cultures. Diagn Microbiol Infect Dis. 2013; 77(1):1-4. DOI: 10.1016/j.diagmicrobio.2013.05.017. View

16.

Tande A, Patel R . Prosthetic joint infection. Clin Microbiol Rev. 2014; 27(2):302-45. PMC: 3993098. DOI: 10.1128/CMR.00111-13. View

17.

Minassian A, Newnham R, Kalimeris E, Bejon P, Atkins B, Bowler I . Use of an automated blood culture system (BD BACTEC™) for diagnosis of prosthetic joint infections: easy and fast. BMC Infect Dis. 2014; 14:233. PMC: 4101863. DOI: 10.1186/1471-2334-14-233. View

18.

Fiori B, DInzeo T, Di Florio V, De Maio F, De Angelis G, Giaquinto A . Performance of two resin-containing blood culture media in detection of bloodstream infections and in direct matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) broth assays for isolate identification:.... J Clin Microbiol. 2014; 52(10):3558-67. PMC: 4187791. DOI: 10.1128/JCM.01171-14. View

19.

Shen H, Tang J, Wang Q, Jiang Y, Zhang X . Sonication of explanted prosthesis combined with incubation in BD bactec bottles for pathogen-based diagnosis of prosthetic joint infection. J Clin Microbiol. 2014; 53(3):777-81. PMC: 4390663. DOI: 10.1128/JCM.02863-14. View

20.

Portillo M, Salvado M, Trampuz A, Siverio A, Alier A, Sorli L . Improved diagnosis of orthopedic implant-associated infection by inoculation of sonication fluid into blood culture bottles. J Clin Microbiol. 2015; 53(5):1622-7. PMC: 4400755. DOI: 10.1128/JCM.03683-14. View