Direct Prosthetic Joint Infection Diagnosis from Sonication Fluid Inoculated in Blood Culture Bottles by Direct MALDI-TOF Mass Spectrometry

Bibliographic Details
Title: Direct Prosthetic Joint Infection Diagnosis from Sonication Fluid Inoculated in Blood Culture Bottles by Direct MALDI-TOF Mass Spectrometry
Authors: Iñaki Beguiristain, Lucia Henriquez, Ignacio Sancho, Carmen Martin, Angel Hidalgo-Ovejero, Carmen Ezpeleta, Maria Eugenia Portillo
Source: Diagnostics, Vol 13, Iss 5, p 942 (2023)
Publisher Information: MDPI AG, 2023.
Publication Year: 2023
Collection: LCC:Medicine (General)
Subject Terms: prosthetic joint infection, sonication, MALDI-TOF, blood culture bottles, Sepsityper, Medicine (General), R5-920
More Details: An accurate and fast microbiological diagnosis is key for a proper management and results when facing prosthetic joint infection (PJI). The purpose of this study is to assess the role of direct Matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry (MS) for early identification of the pathogens causing PJI from sonication fluid inoculated in blood culture bottles (BCB-SF). This prospective multicentric study included 107 consecutive patients from February 2016 to February 2017. Among them, 71 prosthetic joint revision surgeries were undergone for aseptic and 36 for septic reasons. Prostheses were sonicated and the resulting fluid inoculated into blood culture bottles, regardless the suspicion for infection. We assessed the diagnostic performance of direct MALDI-TOF MS identification of the pathogens in BCB-SF and compared it with periprosthetic tissue and conventional sonication fluid cultures. The sensitivity of direct MALDI-TOF MS of BCB-SF (69%) was higher compared to conventional sonication fluid (69% vs. 64%, p > 0.05) or intraoperative tissue cultures (69% vs. 53%, p = 0.04), especially for patients receiving antimicrobial treatment. This approach also reduced the time for identification but the specificity was compromised (100% vs. 94%) and polymicrobial infections were missed. In conclusion, BCB-SF improves the sensitivity and reduces the time of PJI diagnosis when used in combination with conventional cultures under strict sterility conditions.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2075-4418
Relation: https://www.mdpi.com/2075-4418/13/5/942; https://doaj.org/toc/2075-4418
DOI: 10.3390/diagnostics13050942
Access URL: https://doaj.org/article/1d83b6373f1d45ada5ce131f8b44382c
Accession Number: edsdoj.1d83b6373f1d45ada5ce131f8b44382c
Database: Directory of Open Access Journals
Full text is not displayed to guests.
More Details
ISSN:20754418
DOI:10.3390/diagnostics13050942
Published in:Diagnostics
Language:English