title: Prospective Comparison of Blood Culture Bottles and Conventional Swabs for Microbial Identification of Suspected Periprosthetic Joint Infection.
abstract: Early, accurate detection of infection is vital to successful treatment of periprosthetic joint infection (PJI). Currently, no "gold standard" diagnostic testing exists. The goal of this prospective study was to compare the efficacy of a blood culture bottle system (BCBS) to commonly used culture swabs in confirming PJI in patients with high clinical suspicion.
  
  
  
  Patients were selected for enrollment based on Musculoskeletal Infection Society guidelines for PJI. erythrocyte sedimentation rate and C-reactive protein were obtained before aspiration. Aspirated fluid was divided between BCBS, swab, and synovial fluid analysis. Forty-nine samples were analyzed.
  
  
  
  BCBS yielded 41 positive cultures vs 19 with swab (P < .0001), particularly with respect to Staphylococcus epidermidis. There were no false positive results in the BCBS group, using strict Musculoskeletal Infection Society guidelines.
  
  
  
  BCBS increased identification of pathogens in lower extremity PJI, providing clinicians with a low-cost, broadly-applicable test.
authors.affiliation: Department of Orthopaedic Surgery, Center for Hip and Knee Replacement, New York-Presbyterian at Columbia University Medical Center, New York, New York.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Geller
authors.affiliation: Department of Orthopaedic Surgery, Center for Hip and Knee Replacement, New York-Presbyterian at Columbia University Medical Center, New York, New York.
authors.forename: Katherine P
authors.initials: KP
authors.lastname: MacCallum
authors.affiliation: Department of Orthopaedic Surgery, Center for Hip and Knee Replacement, New York-Presbyterian at Columbia University Medical Center, New York, New York.
authors.forename: Taylor S
authors.initials: TS
authors.lastname: Murtaugh
authors.affiliation: Department of Orthopaedic Surgery, Center for Hip and Knee Replacement, New York-Presbyterian at Columbia University Medical Center, New York, New York.
authors.forename: David A
authors.initials: DA
authors.lastname: Patrick
authors.affiliation: Department of Orthopaedic Surgery, Center for Hip and Knee Replacement, New York-Presbyterian at Columbia University Medical Center, New York, New York.
authors.forename: Barthelemy
authors.initials: B
authors.lastname: Liabaud
authors.affiliation: Department of Orthopaedic Surgery, Center for Hip and Knee Replacement, New York-Presbyterian at Columbia University Medical Center, New York, New York.
authors.forename: Venkata K
authors.initials: VK
authors.lastname: Jonna
mesh_terms: D000328:Adult; D000368:Aged; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000382:microbiology*; D000071997:Blood Culture / Q000379:methods*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology*; D013582:Synovial Fluid / Q000737:chemistry / Q000382:microbiology*
chemical_list: D002097:C-Reactive Protein
keywords: blood culture bottles; conventional culture; diagnostic tool; lower extremity arthroplasty; periprosthetic joint infection