A global survey of diagnostic practices in prosthetic joint infections
Por:
Subedi, S, Harris, PN, Chapman, P, Chen, AF, Davis, JS, Liu, PY, Marais, LC, Salles, MJ, Roberts, JA, Rodriguez-Bano, J, Wouthuyzen-Bakker, M, Paterson, DL, Benito, N
Publicada:
1 oct 2025
Ahead of Print:
1 jun 2025
Resumen:
Prosthetic joint infections (PJIs) lead to significant morbidity, mortality and healthcare costs. A timely and accurate microbiological diagnosis is crucial for administering appropriate antimicrobial therapy. Periprosthetic tissue cultures are considered the 'gold standard' for microbiologically diagnosing PJIs. Though International guidelines provide some recommendations for achieving the aetiological diagnosis of PJI, many aspects remain unclear with local practices varying considerably. To better understand these practices, we conducted a global survey to evaluate microbiological diagnostic approaches for PJIs. One hundred and seven hospitals from 24 countries across six continents took part in the survey. Over half of the sites (51.4 %) were from Europe and the majority (79 %) were public hospitals. Nearly half of the sites (49.5 %) reported collecting 5-6 periprosthetic tissue samples for culture; however, 11 % collected fewer than 3 samples. Sonication on explanted joints were done in 46 (43 %) sites. It is noteworthy that 42 % of sites had a culture incubation period of 5 days or less, although 70 % of laboratories extended it under specific circumstances. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) was the most used method for bacterial identification (74.8 %), and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) was the preferred method for susceptibility testing (64.5 % of sites), though notable differences were observed between continents. The availability of polymerase chain reaction (PCR) was limited to 46 (43 %) sites. These global variations in diagnostic practices may contribute to discrepancies in the reported aetiology and percentage of culture-negative PJIs reported in the literature.
Filiaciones:
Subedi, S:
Univ Queensland, UQ Ctr Clin Res, Bldg 71-918 RBWH Herston, Brisbane, Qld 4006, Australia
Sunshine Coast Hosp & Hlth Serv, Britinya, Qld, Australia
Chapman, P:
Royal Brisbane & Womens Hosp, Herston, Qld, Australia
Herston Infect Dis Inst HeIDI, Metro North Hlth, Brisbane, Qld, Australia
Chen, AF:
Univ Texas Southwestern, Dallas, TX USA
Davis, JS:
Univ Newcastle, Hunter Med Res Inst, Infect Res Program, Newcastle, NSW, Australia
Liu, PY:
Taichung Vet Gen Hosp, Div Infect Dis, Taichung, Taiwan
Natl Chung Hsing Univ, Rong Hsing Res Ctr Translat Med, Taichung, Taiwan
Marais, LC:
Univ KwaZulu Natal, Sch Clin Med, Dept Orthopaed Surg, Durban, South Africa
Salles, MJ:
Univ Fed Sao Paulo, Escola Paulista Med EPM, Dept Internal Med, Div Infect Dis, Sao Paulo, Brazil
Roberts, JA:
Univ Queensland, UQ Ctr Clin Res, Bldg 71-918 RBWH Herston, Brisbane, Qld 4006, Australia
Herston Infect Dis Inst HeIDI, Metro North Hlth, Brisbane, Qld, Australia
Royal Brisbane & Womens Hosp, Dept Pharm, Brisbane, Australia
Royal Brisbane & Womens Hosp, Dept Intens Care Med, Brisbane, Australia
Univ Montpellier, Nimes Univ Hosp, Div Anesthesia Crit Care Pain & Emergency Med, UR UM 103,IMAGINE, Nimes, France
Rodriguez-Bano, J:
Hosp Univ Virgen Macarena, Unidad Clin Enfermedades Infecciosas & Microbiol, Seville, Spain
Univ Seville, Dept Med, Seville, Spain
Inst Biomed Sevilla IBiS, CSIC, Seville, Spain
Inst Salud Carlos III, CIBERINFEC CIBER Enfermedades Infecciosas, Madrid, Spain
Wouthuyzen-Bakker, M:
Univ Groningen, Univ Med Ctr Groningen, Dept Med Microbiol & Infect Prevent, Groningen, Netherlands
Paterson, DL:
Univ Queensland, UQ Ctr Clin Res, Bldg 71-918 RBWH Herston, Brisbane, Qld 4006, Australia
Natl Univ Singapore Hosp, Saw Swee Hock Sch Publ Hlth, Adv Id, Singapore, Singapore
Benito, N:
Univ Queensland, UQ Ctr Clin Res, Bldg 71-918 RBWH Herston, Brisbane, Qld 4006, Australia
Inst Salud Carlos III, CIBERINFEC CIBER Enfermedades Infecciosas, Madrid, Spain
Hosp Santa Creu & Sant Pau, Infect Dis Unit, St Antoni Maria Claret 167, Barcelona 08025, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Microbiol Pathol Queensland Cent Lab, Brisbane, Qld, Australia
Green Submitted, Green Accepted, Green Published, hybrid
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