title: Use of broth cultures peri-operatively to optimise the microbiological diagnosis of musculoskeletal implant infections.
abstract: We compared the use of broth culture medium for samples taken in theatre with the standard practice of placing tissue samples in universal containers. A total of 67 consecutive patients had standard multiple samples of deep tissue harvested at surgery and distributed equally in theatre either to standard universal containers or to broth culture medium. These samples were cultured by direct and enrichment methods. The addition of broth in theatre to standard practice led to an increase in sensitivity from 83% to 95% and an increase in negative predictive value from 77% to 91%. Placing tissue samples directly into broth in the operating theatre is a simple, inexpensive way to increase the sensitivity of cultures from infected patients, and does not appear to compromise the specificity of these cultures.
authors.affiliation: Royal Infirmary of Edinburgh, C/o Professor Simpson's Secretary, Department of Trauma and Orthopaedics, 51 Little France Crescent, Edinburgh, EH16 4SA, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Blackmur
authors.affiliation: Newcastle University, Institute of Health and Society, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
authors.forename: E Y H
authors.initials: EY
authors.lastname: Tang
authors.affiliation: Royal London Hospital, Department of Infection, Barts Health NHS Trust, West Smithfield, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Dave
authors.affiliation: University of Edinburgh, Orthopaedic Department, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: A H R W
authors.initials: AH
authors.lastname: Simpson
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D003470:Culture Media; D003937:Diagnosis, Differential; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000382:microbiology; D019637:Orthopedic Procedures / Q000009:adverse effects*; D059035:Perioperative Period; D011237:Predictive Value of Tests; D019736:Prostheses and Implants / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology; D012372:ROC Curve
chemical_list: D003470:Culture Media
keywords: Arthroplasty infection; Bacteria/isolation and purification; Bacterial infections/diagnosis; Bacteriological techniques; Joint Prosthesis/adverse effects; Joint infection; Predictive value of tests; Prosthesis-related infections/microbiology; Sensitivity and specificity