title: Use and cost-effectiveness of intraoperative acid-fast bacilli and fungal cultures in assessing infection of joint arthroplasties.
abstract: The objective of this study is to determine a protocol for collecting acid-fast bacilli (AFB) and fungal intraoperative cultures during orthopedic procedures. An observational study was undertaken. Four hundred forty-six AFB cultures and 486 fungal cultures were processed over a 2-year period. The number of positive cultures was determined. A protocol specific to handling these types of specimens was developed. Cost analysis was completed to determine both the time and money saved if the new protocol was implemented. The infrequency of positive AFB and fungal cultures in this study suggests that it is only necessary to routinely request AFB and fungal cultures on 1 of 5 samples. Implementation of this protocol has potential to lead to substantial cost reduction and resource savings without diminishing patient outcomes.
authors.affiliation: Department of Surgery, Division of Orthopaedic Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Veronica M
authors.initials: VM
authors.lastname: Wadey
authors.forename: James I
authors.initials: JI
authors.lastname: Huddleston
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Goodman
authors.forename: David J
authors.initials: DJ
authors.lastname: Schurman
authors.forename: William J
authors.initials: WJ
authors.lastname: Maloney
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Baron
mesh_terms: D000143:Acids; D001178:Arthroplasty / Q000009:adverse effects*; D001407:Bacillus / Q000302:isolation & purification; D001424:Bacterial Infections / Q000175:diagnosis* / Q000191:economics; D003362:Cost-Benefit Analysis; D004866:Equipment Contamination; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007432:Intraoperative Period; D008828:Microbiological Techniques / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data*; D009181:Mycoses / Q000175:diagnosis* / Q000191:economics; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000191:economics / Q000382:microbiology*; D012189:Retrospective Studies
chemical_list: D000143:Acids