Gram and acridine orange staining for diagnosis of septic arthritis in different patient populations

Cunningham, Gregory; Seghrouchni, Khalid; Ruffieux, Etienne; Vaudaux, Pierre; Gayet-Ageron, Angèle; Cherkaoui, Abdessalam; Godinho, Eduardo; Lew, Daniel Pablo; Hoffmeyer, Pierre; Uçkay, İlker

doi:10.1007/s00264-014-2284-3

Cited by 29 publications

(21 citation statements)

References 23 publications

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“…17 We accepted organisms growing in enrichment broths as pathogens, but did not use organisms identified only by polymerase-chainreaction (PCR) assays, 3 serology, 18 Gram-or acridine orange-stained smears. These decisions were based on the fact that sonication requires explanted hardware, PCR was rarely used, and Gram-staining yields low performances in case of native septic arthritis 7 and hand phlegmona. 13 Thus, incorporating these auxiliary techniques into our final analysis could lead to inconsistencies.…”

Section: Microbiological Analysesmentioning

confidence: 99%

Administration of antibiotic agents before intraoperative sampling in orthopedic infections alters culture results

Al-Mayahi

Cian

Lipsky

et al. 2015

Journal of Infection

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Summary Summary: Many physicians and surgeons think that prescribing antibiotics before intraoperative sampling does not alter the microbiological results. Methods: Case-control study of adult patients hospitalized with orthopedic infections. Results: Among 2740 episodes of orthopedic infections, 1167 (43%) had received antibiotic therapy before surgical sampling. Among these, 220 (19%) grew no pathogens while the proportion of culture-negative results in the 2573 who had no preoperative antibiotic therapy was only 6%. By multivariate analyses, pre-operative antibiotic exposure was associated with significantly more culture-negative results (odds ratio 2.8, 95% confidence interval 2.1e3.7), more non-fermenting rods and skin commensals (odds ratio 2.8 and 3.0, respectively). Even a single pre-operative dose of antibiotic was significantly associated with subsequent culture-negative results (19/93 vs. 297/2350; c 2 -test, p Z 0.01) and skin commensals (17/74 vs. 274/2350; p Z 0.01) compared to episodes without preceding prophylaxis. Conclusions: Prior antibiotic use, including single-dose prophylactic administrations, is three-fold associated with culture-negative results, non-fermenting rods and resistant skin commensals.

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Section: Microbiological Analysesmentioning

confidence: 99%

Administration of antibiotic agents before intraoperative sampling in orthopedic infections alters culture results

Al-Mayahi

Cian

Lipsky

et al. 2015

Journal of Infection

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“…In contrast, much lower sensitivity of AO has been reported in other previous studies [6,19]. The sensitivity of AO and Gram's stain was reported to be equivalent in some studies [9]. Grando et al [20] concluded that there was no clear advantage of AO stain instead of Gram's stain in case of ocular specimens.…”

Section: Discussionmentioning

confidence: 89%

“…Gram's stain and culture are routine methods for laboratory diagnosis of bacterial meningitis in Nepal. However, AO stain has been widely used for the detection of microorganisms in direct smears of clinical specimens including CSF in developing and developed countries [9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Comparison of acridine orange fluorescent microscopy and gram stain light microscopy for the rapid detection of bacteria in cerebrospinal fluid

et al. 2020

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Objective: Bacterial meningitis is a life threatening condition that requires prompt recognition and treatment. Currently, Gram stain is widely used for the microscopic detection of bacterial pathogens in cerebrospinal fluid (CSF). In Nepal, fluorescent microscopes have been installed in laboratories as a part of the National tuberculosis control program. However, information on the utility of the acridine orange (AO) stain for the direct detection of bacteria in CSF samples in Nepal is not available. Therefore, this study aims to compare Gram stain and AO stain for the rapid detection of bacterial pathogens in CSF of clinically suspected meningitis cases in Kathmandu, Nepal.Results: Bacterial pathogens were detected in 9.30% (36/387) by either of the three tests, 9.04% (35/387) by AO stain, 8.27% (32/387) by culture and 6.46% (25/387) by Gram's stain. Considering culture as a gold standard, the sensitivity of AO stain was higher than Gram stain. The specificity of AO stain was 98.87%. Detection and differentiation of the bacteria was much clear in AO staining than Gram staining. AO is a better alternative to Gram stain in the rapid detection of bacterial pathogens in CSF in the setting where fluorescent microscope is available.

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“…Gram stain has a sensitivity and specificity of 37% and 99% respectively, but in the modern era when patients present early, specimens obtained from joint aspiration are often gram-stain negative [146].…”

Section: Joint Aspirationmentioning

confidence: 99%

Septic arthritis in immunocompetent and immunosuppressed hosts

Wang

Tambyah

2015

Best Practice & Research Clinical Rheumatology

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Gram and acridine orange staining for diagnosis of septic arthritis in different patient populations

Cited by 29 publications

References 23 publications

Administration of antibiotic agents before intraoperative sampling in orthopedic infections alters culture results

Administration of antibiotic agents before intraoperative sampling in orthopedic infections alters culture results

Comparison of acridine orange fluorescent microscopy and gram stain light microscopy for the rapid detection of bacteria in cerebrospinal fluid

Septic arthritis in immunocompetent and immunosuppressed hosts

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