[Improving the diagnosis of septic arthritis by use of a pediatric blood culture system].
BACKGROUND
Prognosis and outcome of bacterial joint infections are dependent on the fast and reliable identification of pathogens in the synovial fluid. Previous studies have suggested the possible advantage of using a blood culture system in contrast to conventional culture methods.


METHODS
A total of 101 synovial specimens from patients presenting with symptoms suggesting septic arthritis were taken by aspiration with a sterile syringe. We compared the diagnostic results of automated analysis in a blood culture system against conventional culture on solid agar plates.


RESULTS
Some 67 specimens (66.3%) were found to be negative in both preparations, while samples from 21 patients (20.8%) yielded the same microorganisms. In 13 cases (12.9%), the isolation of a pathogen was possible only with the blood culture method, whereas the conventional method never yielded a positive result when the blood culture was negative. Thus, the diagnostic yield was significantly improved by use of the blood culture system (P <0.001).


CONCLUSIONS
The use of a commonly available blood culture system offers a fast, reliable and cost-effective approach for the diagnosis of septic arthritis and should therefore be considered as an useful alternative to conventional culture methods.
Weiss
S
S
Abteilung Orthopädie I, Stiftung Orthopädische Universitätsklinik Heidelberg.
Geiss
H
H
Kommerell
M
M
Simank
H-G
HG
Bernd
L
L
Henle
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000175:diagnosis* / Q000382:microbiology*; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology*; D001431:Bacteriological Techniques / Q000379:methods*; D002648:Child; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013582:Synovial Fluid / Q000382:microbiology*