General Assembly, Diagnosis, Pathogen Isolation - Culture Matters: Proceedings of International Consensus on Orthopedic Infections

The difference between native septic arthritis and prosthetic joint infections: A review of literature

“…[58][59][60] However, currently, there is insufficient data to support the routine use of sonication and future studies for this method are recommended. 57 In the light of the aforementioned similarities of available clinical diagnostics, it is remarkable to establish that currently positive synovial cultures and purulence are the only common criteria for both types of infection. In former consensus documents about PJIs, purulence was deleted from the definition, but the new consensus has adopted it as a minor criterium again.…”

“…58 –60 However, currently, there is insufficient data to support the routine use of sonication and future studies for this method are recommended. 57…”

“…45 To optimize the identification of microorganism following the removal of prosthesis, sonication could be used. 57 Sonication is the use of low-intensity ultrasound for the disintegration of biofilm on removed implants, and it has been shown to possibly increase the chance of identifying causative microorganisms in the obtained cultures. [58][59][60] However, currently, there is insufficient data to support the routine use of sonication and future studies for this method are recommended.…”

Diagnosis of knee periprosthetic joint infection

“…The laboratory-based test has shown better accuracy (sensitivity = 97% and specificity = 97%) compared with the lateral flow test (sensitivity = 82% and specificity = 96%) [4]. • A minimum of 5 deep samples should be obtained and sent for microbiology [11].…”

Prosthetic Joint Infection: Updates on Prevention, Diagnosis and Therapy

“…These studies influenced our thinking, and those that have ended cultures before the seventh day have had to broadly explain their (mal)practice in meetings and in their publications. The International Consensus Meeting in Philadelphia (2018) recommended that "cultures should be maintained for a period of five to seven days, except cases of low-virulence organisms", where two to three weeks were recommended [17]. However, it is not clear what "except cases of low-virulence" means clinically because when intraoperative samples are taken, no one knows whether the PJI is caused by low-virulence organisms.…”