TY - JOUR
T1 - Treatment With Dithiothreitol Improves Bacterial Recovery From Tissue Samples in Osteoarticular and Joint Infections
AU - De Vecchi, Elena
AU - Bortolin, Monica
AU - Signori, Valentina
AU - Romanò, Carlo L.
AU - Drago, Lorenzo
PY - 2016/2/4
Y1 - 2016/2/4
N2 - Background: Prosthetic implants, periprosthetic and osteoarticular tissues are specimens of choice for diagnosis of bone and joint infections. Homogenization is considered the best procedure for treatment of tissues samples, but, it is not always performed in all laboratories. Dithiothreitol (DTT) has been proposed as an alternative treatment to sonication for microbiological diagnosis of prosthetic joint infections. In this study, the applicability of DTT treatment for processing of periprosthetic and osteoarticular tissues for diagnosis of bone and joint infections was evaluated and compared with normal saline solution treatment. Methods: Periprosthetic tissue samples were collected from 70 consecutive patients (25 infected and 45 not infected). For each patient, samples from the same site were randomly allocated to DTT or saline treatment. Treated samples were centrifuged at 3000 rpm for 10 minutes. Aliquots from the concentrated samples were plated on agar plates and inoculated in broths. Sensitivity and specificity were calculated for each treatment. Results: Microbial growth was observed in samples from 14 and 11 infected patients after DTT and saline treatments, respectively. Concordance between the 2 methods was observed in the 85.7% of cases. Sensitivity was 88.0% for DTT and 72.0% for saline. Specificity was 97.8% and 91.1% for DTT and saline, respectively. Treatment with DTT showed higher sensitivity and specificity with respect to the method routinely used in our laboratory. Conclusion: DTT treatment may be considered a practicable strategy for microbiological analysis of tissues for diagnosis of bone and joint infections.
AB - Background: Prosthetic implants, periprosthetic and osteoarticular tissues are specimens of choice for diagnosis of bone and joint infections. Homogenization is considered the best procedure for treatment of tissues samples, but, it is not always performed in all laboratories. Dithiothreitol (DTT) has been proposed as an alternative treatment to sonication for microbiological diagnosis of prosthetic joint infections. In this study, the applicability of DTT treatment for processing of periprosthetic and osteoarticular tissues for diagnosis of bone and joint infections was evaluated and compared with normal saline solution treatment. Methods: Periprosthetic tissue samples were collected from 70 consecutive patients (25 infected and 45 not infected). For each patient, samples from the same site were randomly allocated to DTT or saline treatment. Treated samples were centrifuged at 3000 rpm for 10 minutes. Aliquots from the concentrated samples were plated on agar plates and inoculated in broths. Sensitivity and specificity were calculated for each treatment. Results: Microbial growth was observed in samples from 14 and 11 infected patients after DTT and saline treatments, respectively. Concordance between the 2 methods was observed in the 85.7% of cases. Sensitivity was 88.0% for DTT and 72.0% for saline. Specificity was 97.8% and 91.1% for DTT and saline, respectively. Treatment with DTT showed higher sensitivity and specificity with respect to the method routinely used in our laboratory. Conclusion: DTT treatment may be considered a practicable strategy for microbiological analysis of tissues for diagnosis of bone and joint infections.
KW - Bone and joint infection
KW - Dithiothreitol
KW - Laboratory diagnosis
KW - Periprosthetic tissue
KW - Sample treatment
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U2 - 10.1016/j.arth.2016.05.008
DO - 10.1016/j.arth.2016.05.008
M3 - Article
AN - SCOPUS:84973573466
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
SN - 0883-5403
ER -