J Bone Jt Infect 2020; 5(3):145-150. doi:10.7150/jbji.44621

Research Paper

Culturing Periprosthetic Tissues in BacT/Alert® Virtuo Blood Culture Bottles for a Short Duration of Post-operative Empirical Antibiotic Therapy

Claire Duployez1,4✉, Frédéric Wallet1, Henri Migaud2,4, Eric Senneville3,4, Caroline Loiez1

1. Institute of Microbiology, Lille University Hospital, 59037 Lille, France
2. Orthopaedic Department, Lille University Hospital, 59037 Lille, France
3. Infectious Diseases Department, Gustave Dron Hospital, 59200 Tourcoing, France
4. University Hospital of Lille, 59037 Lille, France

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Citation:
Duployez C, Wallet F, Migaud H, Senneville E, Loiez C. Culturing Periprosthetic Tissues in BacT/Alert® Virtuo Blood Culture Bottles for a Short Duration of Post-operative Empirical Antibiotic Therapy. J Bone Jt Infect 2020; 5(3):145-150. doi:10.7150/jbji.44621. Available from http://www.jbji.net/v05p0145.htm

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Abstract

Introduction: A post-operative empirical antibiotic therapy (PEAT) is required in periprosthetic joint infections. It commonly uses broad-spectrum antibiotics to cover most Gram-positive cocci and Gram-negative bacilli. It is currently continued until first microbiological results are available, no less than five days later.

Methods: We performed a retrospective study in order to evaluate duration of incubation required for surgical samples using the BacT/Alert® Virtuo blood culture bottles system.

Results: Among 216 surgical interventions and 199 clinical strains (53.8% staphylococci, 22,1% streptococci and enterococci, 14,6% Gram-negative bacilli, 5,5% anaerobes), 90.5% of the strains were detected between day 0 and day 2; 15 infective strains are cultured from day 3 including 8 Cutibacterium sp., 4 staphylococci, 2 streptococci and 1 Enterococcus.

Conclusions: We suggest that the duration of PEAT in patients operated for a periprosthetic joint infection may be shortened to three days as Gram-negative rods are unlikely to grow after three days of culture by using BacT/Alert® Virtuo blood culture bottles. This is likely to shorten the overall length of hospital stay, to diminish the occurrence of adverse side effects, and the emergence of antimicrobial resistance. However, coverage of Gram-positive cocci should be maintained for 14 days until the definite culture results are available.

Keywords: prosthetic joint infection, post-operative empirical antibiotic therapy, optimal duration of culture