Comparing the effectiveness of two culture media techniques in the diagnosis of prosthetic joint infection

Öz

Purpose: When infectious diseases are suspected, culture studies ensure the selection of the appropriate antimicrobial treatment and confirm the diagnosis. There are various differences in medium, sample collection technique, enrichment, and evaluation techniques. Culture sampling makes important contributions to the diagnosis and treatment of prosthetic joint infections, the frequency of which has increased in recent years as a result of the increased rate of arthroplasty. After evaluating the preoperative and intraoperative criteria together, prosthetic joint infections can be diagnosed in suspected cases without culture positivity. This study aims to evaluate different culture samplings efficiency for the diagnosis of prosthetic joint infection. Methods: This study retrospectively evaluated 946 patients who had been sampled in our department between January 2005 and May 2015. These patients were divided into two groups according to their final diagnoses: group one (prosthetic joint infection) and group two (suspected but non-infected prosthetic joint replacement). Considering patients' final diagnoses, this study aimed to compare the results of the blood culture bottle (BCB) method and the standard sterile fluid culture method. Results: When cultivated in a blood culture flask, the sensitivity of the culture test was 28.09%, specificity was 95.77%, and accuracy was 58.13%. When cultivated in a solid medium, sensitivity was 10.11%, specificity was 100%, and accuracy was 50%. Conclusions:When prosthetic joint infection is suspected, BCB usage is a preferable, safer method compared to the standard sterile fluid culture method because it has the power to isolate more bacteria with a higher diagnostic value.

Anahtar Kelimeler

• blood culture bottles
• culture assay
• bacterial identification
• diagnostic accuracy
• prosthetic joint infection

Protez eklem enfeksiyonunun tanısında iki kültür ortamı tekniğinin etkinliğinin karşılaştırılması

Öz

Amaç: Bulaşıcı hastalıklardan şüphelenildiğinde, kültür çalışmaları uygun antimikrobiyal tedavinin seçilmesini sağlar ve tanıyı doğrular. Ortam, örnek toplama tekniği, zenginleştirme ve değerlendirme tekniklerinde çeşitli farklılıklar vardır. Kültür örneklemesi, son yıllarda artroplasti oranının artmasıyla sıklığı artan protez eklem enfeksiyonlarının tanı ve tedavisine önemli katkılar sağlar. Ameliyat öncesi ve sırasındaki kriterlerin birlikte değerlendirilmesiyle, şüpheli vakalarda kültür pozitifliği olmadan protez eklem enfeksiyonları teşhis edilebilir. Bu çalışma, protez eklem enfeksiyonunun tanısı için farklı kültür örneklemelerinin etkinliğini değerlendirmeyi amaçlamaktadır. Yöntemler: Bu çalışmada, Ocak 2005 ile Mayıs 2015 arasında bölümümüzde örneklenen 946 hasta retrospektif olarak değerlendirildi. Bu hastalar nihai tanılarına göre iki gruba ayrıldı: birinci grup (protez eklem enfeksiyonu) ve ikinci grup (şüpheli ancak enfekte olmayan protez eklem replasmanı). Hastaların son tanıları göz önünde bulundurularak, bu çalışmada kan kültürü şişesi (BCB) yöntemi ile standart steril sıvı kültür yönteminin sonuçları karşılaştırılmıştır. Sonuçlar: Kan kültürü şişesinde kültür yapıldığında, kültür testinin duyarlılığı %28,09, özgüllüğü %95,77 ve doğruluğu %58,13 olarak bulunmuştur. Katı bir ortamda kültür yapıldığında, duyarlılığı %10,11, özgüllüğü %100 ve doğruluğu %50 olarak bulunmuştur. Sonuçlar: Protez eklem enfeksiyonundan şüphelenildiğinde, BCB kullanımı daha yüksek tanı değerine sahip daha fazla bakteri izole etme gücüne sahip olduğundan standart steril sıvı kültür yöntemine kıyasla tercih edilen, daha güvenli bir yöntemdir.

Anahtar Kelimeler

• protez eklem enfeksiyonu
• kültür testi
• bakteriyel tanımlama
• tanısal doğruluk
• kan kültürü şişeleri

Kaynakça

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