Unexpected Positive Cultures During Aseptic Hip and Knee Revision Arthroplasty: Substantial Discrepancies in Laboratory Analyses
Abstract
:1. Introduction
2. Results
2.1. Demographics
2.2. Laboratory Results
3. Discussion
4. Materials and Methods
4.1. Study Design
4.2. Revision Surgery and Sample Collection
4.3. Sample Processing
4.4. Interpretation of Positive Bacterial Results
4.5. Statistical Analysis
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
EBJIS | European Bone and Joint Infection Society; |
IDSA | Infectious Diseases Society of America; |
PJI | periprosthetic joint infection; |
PMN | polymorphonuclear leukocyte percentage; |
Spp. | species; |
THA | total hip arthroplasty; |
TKA | total knee arthroplasty; |
UPIC | unexpected positive intraoperative cultures; |
WBC | white blood cell. |
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Patient No. | Sex | Age (y) | Revision TKA/THA | Reason for Revision | Follow-Up (m) | Re-Revision | Pathogen Spectrum Laboratory 1 | Pathogen Spectrum Laboratory 2 | Preoperative Joint Aspiration | Histology | |
---|---|---|---|---|---|---|---|---|---|---|---|
WBC Count | PMN (%) | M and K Type | |||||||||
1 | m | 60.8 | TKA | wear | 59 | no | - | C. acnes (1, s) | 1800 | 12 | 1 |
2 | f | 58.2 | THA | loosening | 63 | no | S. capitis (1, e) | - | n.a. | n.a. | 1 |
3 | m | 89.5 | THA | loosening | 0 a | no | - | Corynebacterium spp. (1, e) | 3500 | 24 | 1 |
4 | f | 77.3 | THA | fracture | 2 | no | S. epidermidis (1, s) | S. epidermidis (3, s), E. coli (1, e) | 13,100 b | 75 | - |
5 | f | 77.6 | THA | loosening | 1 | no | S. epidermidis (1, s) | - | n.a. | n.a. | 4 |
6 | m | 82.3 | TKA | loosening | 15 | no | - | C. acnes (2, e) | 2200 | 10 | 1 |
7 | f | 85.0 | THA | instability | 0 | no | S. auricularis (1, e) | - | 2500 | 43 | 1 |
8 | f | 77.3 | THA | fracture | 28 | no | - | S. epidermidis (1, e) | - | - | 4 |
9 | f | 83.0 | THA | loosening | 1 a | no | S. capitis (1, s) | - | n.a. | n.a. | 3 |
10 | m | 86.2 | TKA | fracture | 20 | yes | Kocuria kristinae (1, e) | - | 14,350 b | 46 | 1 |
11 | m | 76.4 | TKA | loosening | 0 a | no | - | C. acnes (2, e) | 200 | 6 | 1 |
12 | m | 87.8 | THA | wear | 35 | no | E. coli (1, e) Enterococcus spp. (1, s) | - | 4300 | 46 | 1 |
13 | f | 76.8 | TKA | wear | 12 | no | - | Paenibacillus spp. (1, e) | 1200 | 12 | 4 |
14 | f | 75.4 | TKA | loosening | 22 | no | K. pneumoniae (1, a) | - | 1750 | 17 | 1 |
15 | m | 81.6 | THA | wear | 6 | no | - | C. acnes (1, s) | n.a. | n.a. | 4 |
16 | m | 66.8 | THA | wear | 20 | no | Kocuria rosea (1, e) | C. acnes (1, s) Paenebacillus spp. (1, e) | 5600 b | 55 | 1 |
17 | m | 73.4 | THA | wear | 8 | no | - | Micrococcus luteus (1, e) | n.a. | n.a. | 4 |
18 | m | 93.9 | THA | fracture | 24 | no | Streptococcus spp. (1, e) | Acinetobacter spp. (1, e) | - | - | 4 |
Laboratory 1 | Laboratory 2 | ||||
---|---|---|---|---|---|
Coagulase-negative Staphylococci hereof: | 5 | Cutibacterium acnes | 7 | ||
S. capitis | 2 | ||||
S. epidermidis | 2 | ||||
S. auricularis | 1 | ||||
Streptococcus sanguinis | 1 | Coagulase-negative Staphylococci hereof: | 4 | ||
S. epidermidis | 4 | ||||
Enterococcus spp. | 1 | Paenibacillus spp. | 2 | ||
Klebsiella pneumoniae | 1 | Escherichia coli | 1 | ||
Kocuria kristinae | 1 | Corynebacterium | 1 | ||
Kocuria rosea | 1 | Micrococcus luteus | 1 | ||
Escherichia coli | 1 | Acinetobacter spp. | 1 |
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Ludwig, M.; Fuchs, M.; Trappe, O.; Oltmanns, M.; Reichel, H.; Freitag, T. Unexpected Positive Cultures During Aseptic Hip and Knee Revision Arthroplasty: Substantial Discrepancies in Laboratory Analyses. Antibiotics 2025, 14, 372. https://doi.org/10.3390/antibiotics14040372
Ludwig M, Fuchs M, Trappe O, Oltmanns M, Reichel H, Freitag T. Unexpected Positive Cultures During Aseptic Hip and Knee Revision Arthroplasty: Substantial Discrepancies in Laboratory Analyses. Antibiotics. 2025; 14(4):372. https://doi.org/10.3390/antibiotics14040372
Chicago/Turabian StyleLudwig, Marius, Michael Fuchs, Olivia Trappe, Moritz Oltmanns, Heiko Reichel, and Tobias Freitag. 2025. "Unexpected Positive Cultures During Aseptic Hip and Knee Revision Arthroplasty: Substantial Discrepancies in Laboratory Analyses" Antibiotics 14, no. 4: 372. https://doi.org/10.3390/antibiotics14040372
APA StyleLudwig, M., Fuchs, M., Trappe, O., Oltmanns, M., Reichel, H., & Freitag, T. (2025). Unexpected Positive Cultures During Aseptic Hip and Knee Revision Arthroplasty: Substantial Discrepancies in Laboratory Analyses. Antibiotics, 14(4), 372. https://doi.org/10.3390/antibiotics14040372