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Is an isolated positive sonication fluid culture in revision arthroplasties clinically relevant? | LitMetric

AI Article Synopsis

  • The study aimed to determine if patients with an isolated positive sonication fluid culture (SFC) after revision surgery for prosthetic joints have a higher infection rate compared to those with a negative SFC.
  • It analyzed data from 95 patients with positive SFC and 201 controls with negative SFC, finding infection rates of 12.6% and 7.0%, respectively, though the difference wasn't statistically significant.
  • The findings suggest infections are more common in positive SFC patients, highlighting the need for larger trials to better understand the impact of antibiotic treatment in these cases.

Article Abstract

Objectives: The aim of this study was to investigate the clinical relevance of an isolated positive sonication fluid culture (SFC) in patients who underwent revision surgery of a prosthetic joint. We hypothesized that cases with a positive SFC have a higher rate of infection during follow-up compared with controls with a negative SFC.

Methods: This retrospective multicentre observational study was performed within the European Study Group of Implant-Associated Infections. All patients who underwent revision surgery of a prosthetic joint between 2013 and 2019 and had a minimum follow-up of 1 year were included. Patients with positive tissue cultures or synovial fluid cultures were excluded from the study.

Results: A total of 95 cases (positive SFC) and 201 controls (negative SFC) were included. Infection during follow-up occurred in 12 of 95 cases (12.6%) versus 14 of 201 controls (7.0%) (p = 0.125). In all, 79.8% of cases were with treated with antibiotics (76/95). Of the non-treated cases, 89% (17/19) had a positive SFC with a low virulent microorganism. When solely analysing patients who were not treated with antibiotics, 16% of the cases (3/19) had an infection during follow-up versus 5% of the controls (9/173) (p = 0.08).

Discussion: Although not statistically significant, infections were almost twice as frequent in patients with an isolated positive SFC. These findings require further exploration in larger trials and to conclude about the potential benefit of antibiotic treatment in these cases.

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Source
http://dx.doi.org/10.1016/j.cmi.2023.07.018DOI Listing

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