The State of Microbiology Diagnostic of Prosthetic Joint Infection in Europe: An In-Depth Survey Among Clinical Microbiologists

Erlangga Yusuf*, Charlotte Roschka, ESCMID Study Group for Implant-Associated Infections (ESGIAI), Jaime Esteban, Annibale Raglio, Anna Tisler, Philippe Willems, Tobias Siegfried Kramer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: This study aims to give an overview on how microbiology diagnosis tests of Prosthetic joint infections (PJI) is performed in Europe, and to explore whether any factor influences the decision on implementing a test. Methods: An extensive online survey of clinical microbiologists from seven European countries (Belgium, Estonia, Germany, Italy, Netherlands, Switzerland, and Spain). Following items were assessed: (i). general information on the laboratory, (ii) preference of the laboratory and clinical microbiologists regarding samples, (iii) transportation and (iv) processing of explanted foreign bodies and tissues and synovial fluid, (v) culture media and culture duration, (vi) reporting (identification and susceptibility testing), and (vii) use of molecular microbiology techniques. Results: Invited were 163 clinical microbiologists. The response rate from each country was above 50% (range 51–78%), except for Germany (36%). Frequent PJI diagnostics were the use of tissue pre-processing (58.1%), culturing synovial fluid in blood culture bottles (45.5%), use of sonication for processing explanted prosthesis (56.8%), reporting the presence of synovial leukocyte counts (67%), use of blood aerobic and anaerobic agar (97.7%), and enrichment media thioglycolate (69.3%). The most common incubation time of the culture media is 7–14 days (34.1–70.5%). The clinicians were called to report the culture results (80.7%), and to give antibiotic recommendation (67%). Conclusion: There are common practices in processing PJI samples and reporting results, which is promising for harmonization of PJI diagnostic in the future. However, variation in diagnostic tests should also be considered in interpreting and comparing clinical microbiology results.

Original languageEnglish
Article number906989
JournalFrontiers in Microbiology
Publication statusPublished - 20 Jun 2022

Bibliographical note

Funding Information:
We thank all of our colleagues who could participate with this survey. We appreciate your contribution and effort despite increased work load during the COVID-19 pandemic. We are especially thankful to Adrian Egli, head of Clinical Bacteriology and Mycology, University Hospital Basel, Switzerland for his invaluable comments on this manuscript.

Publisher Copyright:
Copyright © 2022 Yusuf, Roschka, Esteban, Raglio, Tisler, Willems and Kramer.


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