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- Title
Dithiotreitol pre-treatment of synovial fluid samples improves microbiological counts in peri-prosthetic joint infection.
- Authors
Drago, Lorenzo; Romanò, Delia; Fidanza, Andrea; Giannetti, Alessio; Erasmo, Rocco; Mavrogenis, Andreas F.; Romanò, Carlo Luca
- Abstract
Purpose: Synovial fluid cultures of periprosthetic joint infections (PJI) may be limited by bacteria living in the fluids as biofilm-aggregates. The antibiofilm pre-treatment of synovial fluids with dithiotreitol (DTT) could improve bacterial counts and microbiological early stage diagnosis in patients with suspected PJI. Methods: Synovial fluids collected from 57 subjects, affected by painful total hip or knee replacement, were divided into two aliquots, one pre-treated with DTT and one with normal saline. All samples were plated for microbial counts. Sensitivity of cultural examination and bacterial counts of pre-treated and control samples were then calculated and statistically compared. Results: Dithiothreitol pre-treatment led to a higher number of positive samples, compared to controls (27 vs 19), leading to a statistically significant increase in the sensitivity of the microbiological count examination from 54.3 to 77.1% and in colony-forming units count from 1884 ± 2.129 CFU/mL with saline pre-treatment to 20.442 ± 19.270 with DTT pre-treatment (P = 0.02). Conclusions: To our knowledge, this is the first report showing the ability of a chemical antibiofilm pre-treatment to increase the sensitivity of microbiological examination in the synovial fluid of patients with peri-prosthetic joint infection. If confirmed by larger studies, this finding may have a significant impact on routine microbiological procedures applied to synovial fluids and brings further support to the key role of bacteria living in biofilm-formed aggregates in joint infections.
- Subjects
JOINT infections; SYNOVIAL fluid; PLATE counts (Microbiology); TOTAL hip replacement; TOTAL knee replacement
- Publication
International Orthopaedics, 2023, Vol 47, Issue 5, p1147
- ISSN
0341-2695
- Publication type
Article
- DOI
10.1007/s00264-023-05714-z