The role of sonication in the diagnosis of prosthetic joint infections
Abstract
Prosthetic joint infection represent a severe complication after joint arthtroplasty and causes severe patient morbidity, along with the financial burden for the healthcare system. The number of patients after joint arthtroplasty increases with the ageing population, therefore there is an increase in the incidence of complications. The pathogenesis of medical device infection is based on the developement of bacterial biofilm, a diagnostic and therapeutic obstacle. The implementation of a new diagnostic tool – sonication, enables disruption of bacterial biofilm and improves the sensitivity of microbiological tests, even after preoperative antimicrobial therapy. The use of sonication has shown to be crucial in doubtful cases, where the distinction between aseptic failure and prosthetic joint infection is blurred because of the absence of clinical signs of infection or negative periprosthetic tissue cultures.
Downloads
References
Steckelberg JM, Osmon DR. Prosthetic joint infections. In: Bisno AL,Waldvogel FA ed. Infections associated with indwelling medical devices. Washington: American Society for Microbiology 1994: 259–90.
Kadoya Y, Kobayashi A, Ohashi H. Wear and osteolysis in total joint replacements. Acta Orthop Scand Suppl 1998; 278: 1–16.
Berbari EF, Hanssen AD, Duffy MC, Steckelberg JM, Ilstrup DM, Harmsen WS, et al. Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis 1998; 27: 1247–54.
Klouche S, Sariali E, Mamoudy P. Total hip arthroplasty revision due to infection: a cost analysis approach. Orthop Traumatol Surg Res 2010 Apr; 96 (2): 124-32.
Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-Joint Infections. N Engl J Med 2004; 351: 1645-54.
Dolinar D, Koritnik B, Meglič-Volkar J, Lotrič-Furlan S. Preprečevanje in principi zdravljenja proteznih okužb v ortopediji. Zdrav Vestn 2007; 76: 117–24.
Giulieri SG, Graber P, Ochsner PE, Zimmerli W. Management of infection associated with total hip arthroplasty according to a treatment algorithm. Infection 2004; 32: 222-8.
Maurer TB, Ochsner PE. Infekt nach Knietotalprothesenimplantation. Zweizeitiger Wechsel als Element des Liestaler Behandlungsalgorithmus. Orthopade 2006 Sep; 35 (9): 917-8, 920-8.
Trampuz A, Zimmerli W. Prosthetic joint infections: update in diagnosis and treatment. Swiss Med Wkly 2005; 135: 243–51.
Harris WH, Sledge CB. Total hip and total knee replacement. N Engl J Med 1990 Sep 20; 323 (12): 801-7.
Piper KE, Jacobson MJ, Cofield RH, Sperling JW, Sanchez-Sotelo J, Osmon DR, et al. Microbiologic Diagnosis of Prosthetic Shoulder Infection by Use of Implant Sonication. J Clin Microbiol 2009 Jun; 47 (6): 1878-84.
Ainscow DA, Denham RA. The risk of haematogenous infection in total joint replacements. J Bone Joint Surg Br 1984 Aug; 66 (4): 580-2.
Murdoch DR, Roberts SA, Fowler VG Jr, Shah MA, Taylor SL, Morris AJ, et al. Infection of orthopedic prostheses after Staphylococcus aureus bacteremia. Clin Infect Dis 2001 Feb 15; 32 (4): 647-9.
Krijnen P, Kaandorp C, Steyerberg E, van Schaardenburg D, Moens H, Habbema J. Antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease: a cost effectiveness analysis. Ann Rheum Dis 2001 April; 60 (4): 359–66.
American Dental Association, American Academy Of Orthopaedic Surgeons. Antibiotic prophylaxis for dental patients with total joint replacements. JADA 2003; 134: 895-9.
Trampuz A, Widmer AF. Infections associated with orthopedic implants. Current Opinion in Infectious Diseases 2006; 19: 349-56.
Lentino JR. Prosthetic joint infections: bane of orthopedists, challenge for infectious disease specialists. Clin Infect Dis 2003; 36 (9): 1157-61.
Stewart PS, Costerton JW. Antibiotic resistance of bacteria in biofilms. Lancet 2001; 358: 135–8.
Costerton JW, Lewandowski Z, Caldwell DE, Korber DR, Lappin-Scott HM. Microbial biofilms. Annu Rev Microbiol 1995: 711–45.
Trampuz A, Kavcic M, Grmek-Kosnik I, Trebse R. Primerjava kulture sinovialne tekočine, obproteznega tkiva in sonikata proteze v diagnostiki okužb kolenskih protez. Zdrav Vestn 2003; 72: 117-25.
Bjerkan G, Witsø E, Bergh K. Sonication is superior to scraping for retrieval of bacteria in biofilm on titanium and steel surfaces in vitro. Acta Orthopaedica 2009; 80 (2): 245–50.
Cataldo MA, Petrosillo N, Cipriani M, Cauda R, Tacconelli E. Prosthetic joint infection: Recent developments in diagnosis and management. J Infect (2010) 61, 443-8.
Francés Borrego A, Martínez FM, Cebrian Parra JL, Grañeda DS, Crespo RG, López-Durán Stern L. Diagnosis of infection in hip and knee revision surgery: intraoperative frozen section analysis. Int Orthop. 2007 Feb; 31 (1): 33-7.
Workgroup Convened by the Musculoskeletal Infection Society. New definition for periprosthetic joint infection. J Arthroplasty 2011 Dec; 26(8): 1136-8.
Dobbins JJ, Seligson D, Raff MJ. Bacterial colonization of orthopedic fixation devices in the absence of clinical infection. J Infect Dis 1988; 158: 203–5.
Nelson CL, McLaren AC, McLaren SG, Johnson JW, Smeltzer MS. Is aseptic loosening truly aseptic? Clin Orthop Relat Res. 2005 Aug; (437): 25-30.
Holinka J, Bauer L, Hirschl AM, Graninger W, Windhager R, Presterl E. Sonication cultures of explanted components as an add-on test to routinely conducted microbiological diagnostics improve pathogen detection. J Orthop Res 2011 Apr; 29 (4): 617-22.
Moojen DJ, van Hellemondt G, Vogely HC, Burger BJ, Walenkamp GH, Tulp NJ, et al. Incidence of low-grade infection in aseptic loosening of total hip arthroplasty. Acta Orthop. 2010 Dec; 81 (6): 667-73.
Berbari EF, Marculescu C, Sia I, Lahr BD, Hanssen AD, Steckelberg JM, et al. Culture-negative prosthetic joint infection. Clin Infect Dis. 2007 Nov 1; 45 (9): 1113-9.
Sierra JM, García S, Martínez-Pastor JC, Tomás X, Gallart X, Vila J, et al. Relationship between the degree of osteolysis and cultures obtained by sonication of the prostheses in patients with aseptic loosening of a hip or knee arthroplasty. Arch Orthop Trauma Surg. 2011 Oct; 131 (10): 1357-61.
Malekzadeh D, Osmon DR, Lahr BD, Hanssen AD, Berbari EF. Prior use of antimicrobial therapy is a risk factor for culture-negative prosthetic joint infection. Clin Orthop Relat Res. 2010 Aug; 468 (8): 2039-45.
Trampuz A, Piper KE, Jacobson MJ, Hanssen AD, Unni KK, Osmon DR, et al. Sonication of removed hip and knee prostheses for diagnosis of infection. N Engl J Med 2007 Aug 16; 357 (7): 654-63.
Kobayashi N, Bauer TW, Tuohy MJ, Fujishiro T, Procop GW. Brief ultrasonication improves detection of biofilm-formative bacteria around a metal implant. Clin Orthop Relat Res 2007 Apr; 457: 210-3.
Del Pozo JL, Tran NV, Petty PM, Johnson CH, Walsh MF, Bite U, et al. Pilot study of association of bacteria on breast implants with capsular contracture. J Clin Microbiol 2009 May; 47 (5): 1333-7.
Trampuz A, Piper KE, Hanssen AD, Osmon DR, Cockerill FR, Steckelberg JM, et al. Sonication of explanted prosthetic components in bags for diagnosis of prosthetic joint infection is associated with risk of contamination. J Clin Microbiol 2006 Feb; 44 (2): 628-31.
Johannsson B, Taylor J, Clark CR, Shamsuddin H, Beekmann SE, Polgreen P. Treatment approaches to prosthetic joint infections: results of an Emerging Infections Network survey. Diagn Microbiol Infect Dis 2010 Jan; 66 (1): 16-23.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
