Abstract
Background
The usefulness of sonicate fluid culture for biological tissues in orthopedic bone
and soft tissue infections have not been reported. We assessed whether inoculating
the sonicate fluid of bone and soft tissue into a blood culture bottle could increase
the diagnostic accuracy for biofilm-related orthopedic infections.
Methods
Twenty consecutive patients with infections (9 purulent arthritis, 4 osteomyelitis,
4 purulent tenosynovitis, 2 purulent bursitis, and 1 cellulitis) and 10 non-infected
cases (6 carpal tunnel syndrome, 3 Dupuytren contracture, and 1 soft tissue tumor)
between October 2018 and December 2020 were evaluated prospectively. We analyzed a
total of 107 culture submissions (87 bone and tissue specimens and 20 controls); 42
intraoperative tissue specimens (32 infected samples and 10 non-infected samples)
using the conventional method, 45 sonication samples (35 infected samples and 10 non-infected
samples), and 20 control samples. Intraoperative infectious tissues were cultured
using sonicate fluid culture in a blood culture bottle (SFC-CB). The applications
of SFC-CB and the conventional culture method and the detection rate, sensitivity,
and relationship between the sensitivity of the diagnostic methods and duration of
administered preoperative antibiotics were assessed.
Results
The causative microorganism was detected only by SFC-CB in five patients (25%). The
sensitivity (85% vs. 60%; P = 0.077) and detection rate (80% vs. 60%; P = 0.065) were
higher for SFC-CB than for the conventional culture method. The sensitivity of SFC-CB
was significantly higher than that of the conventional culture method in cases in
which preoperative antibiotics were administered for more than 1 week (77% vs. 39%;
P = 0.047).
Conclusions
Using SFC-CB, the diagnostic accuracy for bone and soft tissue infection was significantly
improved. As biofilms are readily formed in biological tissues, sonication may also
be useful for diagnosis. SFC-CB was particularly useful for cases in which preoperative
antibiotics were administered.
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Article info
Publication history
Published online: December 28, 2021
Accepted:
November 12,
2021
Received in revised form:
October 16,
2021
Received:
July 14,
2021
Footnotes
☆Our institutional review board (2020024) approved this prospective cohort study.
Identification
Copyright
© 2021 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
