Role of microbiological examination in diagnosis and treatment of periprosthetic infection
Abstract
Objective. Determination of optimal tactics of microbiological investigation in patient, suffering periprosthetic infection (PPI), using estimation of trustworthiness of the bacteriological investigations results in preoperative and postoperative periods.
Маterials and methods. On the base of Orthopedic–Traumatological Centre of Kiev's Regional Clinical Hospital through 2016 – 2018 yrs 32 patients were examined with suspicion on presence of PPI. Two Groups of patients were formatted, in whom during preoperative preparation bacteriological investigation was accomplished: Group I – 23 patients, in whom bacteriological investigation of cultures from fistula was done; Group II – 9 patients, in whom the material for culture was taken by puncture, because the fistula aperture in them was absent.
Results. Of 147 preoperative cultures in 83 (56.5%) Gram–positive cocci were revealed, and in 49 (33.3%) – Gram–negative bacteria; while in 15 (10.2%) cultures the development of microflora was not proved. In 22 (68.7%) cases a monoculture was separated, while in 10 (31.3%) – two and more microorganisms.
Conclusion. Diagnosis of PPI constitutes a complex task and demands application of multidisciplinary approach, which supposes close cooperation of physicians–orthopedics and microbiologists.
References
2. Kates S, Borens O, editors. Principles of Orthopedic Infection Management. Davos: AO Publishing; 2017. 496 p.
3. Filippenko VA, Marushhak AP, Bondarenko SE. Periproteznaja infekcija: diagnostika i lechenie. Chast' 1 (obzor literatury). Ortopedija, travmatologija i protezirovanie. 2016(2):102-10. http://doi.org/10.15674/0030-598720162102-110. [In Russian].
4. Parvizi J, Gehrke T, Chen AF. Proceedings of the international consensus on periprosthetic joint infection. Bone Joint J. 2013 Nov;95-B(11):1450-2. https://doi.org/10.1302/0301-620X.95B11.33135.
5. Tria AJ, Bingham J, Spangehl MJ, Clarke HD, Gehrke T, Zahar A, et al. Management of the Infected Total Knee Arthroplasty. In: Complex Cases in Total Knee Arthroplasty. Cham: Springer; 2018:179-206. https://doi.org/10.1007/978-3-319-69380-4
6. Ivanov PP, Kornilov NN, Kuljaba TA. Revizionnye hirurgicheskie vmeshatel'stva pri periproteznoj infekcii kolennogo sustava (obzor literatury). Kafedra travmatologii i ortopedii. 2017;21(1):35-43. [In Russian].
7. Parvizi J, Gehrke T. Definition of periprosthetic joint infection. J Arthroplasty. 2014(7):1331-4. https.
8. Kolotij AD, Jurov IJu, Demidova IA, Kurinnaja OS, Kravec VS, Zelenova MA, et al. Klassicheskaja citogenetika v jepohu vysokorazreshajushhih molekuljarno-citogeneticheskih tehnologij. Rossijskij vestnik perinatologii i pediatrii. 2018(4):206-7 https://doi.org/10.21508/1027-4065-congress-2018. [In Russian].
Copyright (c) 2019 Liga-Inform
This work is licensed under a Creative Commons Attribution 4.0 International License.