A prospective evaluation of the inoculation of homogenised tissue and bone biopsies in blood culture bottles for the diagnosis of orthopaedic-device-related infections
<p>Fracture-related infections (FRIs) and periprosthetic joint infections (PJIs) occur in nearly 2 % of patients with orthopaedic devices, contributing to significant morbidity and mortality. Effective microbiological diagnosis of these infections remains challenging, with the homogenisation o...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2025-08-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/10/317/2025/jbji-10-317-2025.pdf |
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| Summary: | <p>Fracture-related infections (FRIs) and periprosthetic joint infections (PJIs) occur in nearly 2 % of patients with orthopaedic devices, contributing to significant morbidity and mortality. Effective microbiological diagnosis of these infections remains challenging, with the homogenisation of bone/tissue biopsies recognised as the most reliable pre-analytical procedure.</p>
<p>This prospective study compared the inoculation of homogenised samples into a BacT/ALERT<sup><sup>®</sup></sup> VIRTUO<sup><sup>®</sup></sup> system using FA and FN PLUS blood culture bottles (BCBs) with inoculation into conventional Wilkins–Chalgren broth. Bone and tissue samples collected during surgery for suspected or confirmed FRIs or PJIs were homogenised with saline and glass beads. The resulting suspension was inoculated into BCBs (14 d incubation) or into Wilkins–Chalgren broth (10 d incubation).</p>
<p>Among the 59 patients included, cultures remained negative in 19 cases, whereas both methods successfully identified all pathogens in 28 patients. Although sensitivity was similar between the two methods (85 % for BCB vs. 80 % for the conventional method; <span class="inline-formula"><i>p</i>=0.77</span>), the BCB method demonstrated significantly higher specificity (93 % vs. 56 %; <span class="inline-formula"><i>p</i>=0.0001</span>). The BCB method yielded much faster results, with 80 % of cultures turning positive within the first 2 d of incubation (median of 24.5 h). In contrast only 16 % of cultures processed with the conventional method were positive within the same time frame (median of 69.0 h; <span class="inline-formula"><i>p</i>=0.03</span>). For <i>Cutibacterium acnes</i>, a minimum incubation period of 14 d was necessary with the BCB method to ensure accurate detection.</p>
<p>This prospective study demonstrated an enhanced method for culturing bone and tissue biopsies from patients with FRIs or PJIs using the BacT/ALERT<sup><sup>®</sup></sup> VIRTUO<sup><sup>®</sup></sup> system, resulting in improved specificity and the significantly faster detection of pathogenic microorganisms.</p> |
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| ISSN: | 2206-3552 |