A comparative study of heterogeneous antibiotic resistance of microbial populations in conventional periprosthetic tissue cultures and sonication fluid cultures of orthopaedics explanted prostheses
Background “Heterogeneity” describes a phenomenon where subpopulations of seemingly isogenic bacteria exhibit a range of susceptibilities to a particular antibiotic. We aim to investigate the frequency of heterogeneity among microbes isolated from infected prostheses, and its possible correlation wi...
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| Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2020-10, Vol.30 (7), p.1307-1318 |
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| container_title | European journal of orthopaedic surgery & traumatology |
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| creator | Banousi, Angeliki Evangelopoulos, Dimitrios S. Stylianakis, Antonios Fandridis, Emmanouil Chatziioannou, Sofia Sipsas, Nikolaos V. Pneumaticos, Spyridon G. |
| description | Background
“Heterogeneity” describes a phenomenon where subpopulations of seemingly isogenic bacteria exhibit a range of susceptibilities to a particular antibiotic. We aim to investigate the frequency of heterogeneity among microbes isolated from infected prostheses, and its possible correlation with microbial resistance.
Methods
Between May 2014 and June 2019, we investigated 234 patients, at our institution, undergoing revision arthroplasty because of loosening of the prostheses or because of periprosthetic joint infection. All patients had periprosthetic tissue culture, sonication of prosthesis and direct inoculation of Sonication fluid into blood culture bottles. We assessed the presence of heterogeneity among all pathogens isolated from infected prostheses.
Results
Using standard non-microbiological criteria to determine periprosthetic joint infection, it was found that 143 patient (61.1%) had aseptic loosening while 91 patients (38.9%) had periprosthetic joint infection. Comparing the two methods, the results of our study showed that the method of sonication was significantly more sensitive than tissue culture [91% (83–96) vs. 43% (33–54);
p
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| doi_str_mv | 10.1007/s00590-020-02704-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2406581071</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2406581071</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-7f62ddb196d045e963724eb964258f96f678ed2b1bed9828e8d2b062c0a2deca3</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhSNUREvbF2CBvGQTsB3HSZZVxZ9UiQ2sLceetK6SOHjsij4g78Wk9wK7Lix7NGe-sc6pqjeCvxecdx-Q83bgNZf76biq1YvqTKhG1oLr_oTeumnqnuv2tHqNeM-5aAfRvqpOG6nUwHtxVv2-Yi4um002hwdgmIt_ZHFid5AhxVtYIRZkds1hDDEHxxJgwGxXB7tsCS7FMdiZbXErM0HiiiysBF0fYN3LvQcpbCliJiohckAswFyZcyEc0T3DuAb3NM6muQT_v0tbYsp3cbPgg0MGv7aZ_gOeHZEIeFG9nOyMcHm8z6sfnz5-v_5S33z7_PX66qZ2jepy3U1aej-KQXuuWhh000kF46CVbPtp0JPuevByFCP4oZc99FRwLR230oOzzXn17sCl1T8LYDZLQAczfWj3yUhFZveCd4Kk8iAlgxATTGZLYbHp0Qhu9vjMIT5D8Zmn-IyiobdHfhkX8P9G_uZFguYgQGqtt5DMfSyJPMbnsH8ANketng</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2406581071</pqid></control><display><type>article</type><title>A comparative study of heterogeneous antibiotic resistance of microbial populations in conventional periprosthetic tissue cultures and sonication fluid cultures of orthopaedics explanted prostheses</title><source>SpringerLink Journals</source><creator>Banousi, Angeliki ; Evangelopoulos, Dimitrios S. ; Stylianakis, Antonios ; Fandridis, Emmanouil ; Chatziioannou, Sofia ; Sipsas, Nikolaos V. ; Pneumaticos, Spyridon G.</creator><creatorcontrib>Banousi, Angeliki ; Evangelopoulos, Dimitrios S. ; Stylianakis, Antonios ; Fandridis, Emmanouil ; Chatziioannou, Sofia ; Sipsas, Nikolaos V. ; Pneumaticos, Spyridon G.</creatorcontrib><description>Background
“Heterogeneity” describes a phenomenon where subpopulations of seemingly isogenic bacteria exhibit a range of susceptibilities to a particular antibiotic. We aim to investigate the frequency of heterogeneity among microbes isolated from infected prostheses, and its possible correlation with microbial resistance.
Methods
Between May 2014 and June 2019, we investigated 234 patients, at our institution, undergoing revision arthroplasty because of loosening of the prostheses or because of periprosthetic joint infection. All patients had periprosthetic tissue culture, sonication of prosthesis and direct inoculation of Sonication fluid into blood culture bottles. We assessed the presence of heterogeneity among all pathogens isolated from infected prostheses.
Results
Using standard non-microbiological criteria to determine periprosthetic joint infection, it was found that 143 patient (61.1%) had aseptic loosening while 91 patients (38.9%) had periprosthetic joint infection. Comparing the two methods, the results of our study showed that the method of sonication was significantly more sensitive than tissue culture [91% (83–96) vs. 43% (33–54);
p
< 0.005]. In this study, heterogeneity was reported in 15 cases, 16.5% of all infections and 6.4% in the total population. In our study,
Staphylococcus
epidermidis
was the most commonly isolated strain followed by
Staphylococcus aureus
, at a rate of 35.2% and 19.8%, respectively. Antibiotics in which the microorganisms exhibited heterogeneous bacterial behavior most frequently were Gendamicin (5.3%), Vancomycin (4.9%).
Conclusion
There is increasing evidence that heterogeneity can lead to therapeutic failure and that the detection of this phenotype is a prerequisite for a proper antibiotic choice to have a successful therapeutic effect.</description><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-020-02704-4</identifier><identifier>PMID: 32449081</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Medicine ; Medicine & Public Health ; Original Article ; Surgical Orthopedics ; Traumatic Surgery</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2020-10, Vol.30 (7), p.1307-1318</ispartof><rights>Springer-Verlag France SAS, part of Springer Nature 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-7f62ddb196d045e963724eb964258f96f678ed2b1bed9828e8d2b062c0a2deca3</citedby><cites>FETCH-LOGICAL-c347t-7f62ddb196d045e963724eb964258f96f678ed2b1bed9828e8d2b062c0a2deca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00590-020-02704-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00590-020-02704-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32449081$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Banousi, Angeliki</creatorcontrib><creatorcontrib>Evangelopoulos, Dimitrios S.</creatorcontrib><creatorcontrib>Stylianakis, Antonios</creatorcontrib><creatorcontrib>Fandridis, Emmanouil</creatorcontrib><creatorcontrib>Chatziioannou, Sofia</creatorcontrib><creatorcontrib>Sipsas, Nikolaos V.</creatorcontrib><creatorcontrib>Pneumaticos, Spyridon G.</creatorcontrib><title>A comparative study of heterogeneous antibiotic resistance of microbial populations in conventional periprosthetic tissue cultures and sonication fluid cultures of orthopaedics explanted prostheses</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>Background
“Heterogeneity” describes a phenomenon where subpopulations of seemingly isogenic bacteria exhibit a range of susceptibilities to a particular antibiotic. We aim to investigate the frequency of heterogeneity among microbes isolated from infected prostheses, and its possible correlation with microbial resistance.
Methods
Between May 2014 and June 2019, we investigated 234 patients, at our institution, undergoing revision arthroplasty because of loosening of the prostheses or because of periprosthetic joint infection. All patients had periprosthetic tissue culture, sonication of prosthesis and direct inoculation of Sonication fluid into blood culture bottles. We assessed the presence of heterogeneity among all pathogens isolated from infected prostheses.
Results
Using standard non-microbiological criteria to determine periprosthetic joint infection, it was found that 143 patient (61.1%) had aseptic loosening while 91 patients (38.9%) had periprosthetic joint infection. Comparing the two methods, the results of our study showed that the method of sonication was significantly more sensitive than tissue culture [91% (83–96) vs. 43% (33–54);
p
< 0.005]. In this study, heterogeneity was reported in 15 cases, 16.5% of all infections and 6.4% in the total population. In our study,
Staphylococcus
epidermidis
was the most commonly isolated strain followed by
Staphylococcus aureus
, at a rate of 35.2% and 19.8%, respectively. Antibiotics in which the microorganisms exhibited heterogeneous bacterial behavior most frequently were Gendamicin (5.3%), Vancomycin (4.9%).
Conclusion
There is increasing evidence that heterogeneity can lead to therapeutic failure and that the detection of this phenotype is a prerequisite for a proper antibiotic choice to have a successful therapeutic effect.</description><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1TAQhSNUREvbF2CBvGQTsB3HSZZVxZ9UiQ2sLceetK6SOHjsij4g78Wk9wK7Lix7NGe-sc6pqjeCvxecdx-Q83bgNZf76biq1YvqTKhG1oLr_oTeumnqnuv2tHqNeM-5aAfRvqpOG6nUwHtxVv2-Yi4um002hwdgmIt_ZHFid5AhxVtYIRZkds1hDDEHxxJgwGxXB7tsCS7FMdiZbXErM0HiiiysBF0fYN3LvQcpbCliJiohckAswFyZcyEc0T3DuAb3NM6muQT_v0tbYsp3cbPgg0MGv7aZ_gOeHZEIeFG9nOyMcHm8z6sfnz5-v_5S33z7_PX66qZ2jepy3U1aej-KQXuuWhh000kF46CVbPtp0JPuevByFCP4oZc99FRwLR230oOzzXn17sCl1T8LYDZLQAczfWj3yUhFZveCd4Kk8iAlgxATTGZLYbHp0Qhu9vjMIT5D8Zmn-IyiobdHfhkX8P9G_uZFguYgQGqtt5DMfSyJPMbnsH8ANketng</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Banousi, Angeliki</creator><creator>Evangelopoulos, Dimitrios S.</creator><creator>Stylianakis, Antonios</creator><creator>Fandridis, Emmanouil</creator><creator>Chatziioannou, Sofia</creator><creator>Sipsas, Nikolaos V.</creator><creator>Pneumaticos, Spyridon G.</creator><general>Springer Paris</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20201001</creationdate><title>A comparative study of heterogeneous antibiotic resistance of microbial populations in conventional periprosthetic tissue cultures and sonication fluid cultures of orthopaedics explanted prostheses</title><author>Banousi, Angeliki ; Evangelopoulos, Dimitrios S. ; Stylianakis, Antonios ; Fandridis, Emmanouil ; Chatziioannou, Sofia ; Sipsas, Nikolaos V. ; Pneumaticos, Spyridon G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-7f62ddb196d045e963724eb964258f96f678ed2b1bed9828e8d2b062c0a2deca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Banousi, Angeliki</creatorcontrib><creatorcontrib>Evangelopoulos, Dimitrios S.</creatorcontrib><creatorcontrib>Stylianakis, Antonios</creatorcontrib><creatorcontrib>Fandridis, Emmanouil</creatorcontrib><creatorcontrib>Chatziioannou, Sofia</creatorcontrib><creatorcontrib>Sipsas, Nikolaos V.</creatorcontrib><creatorcontrib>Pneumaticos, Spyridon G.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Banousi, Angeliki</au><au>Evangelopoulos, Dimitrios S.</au><au>Stylianakis, Antonios</au><au>Fandridis, Emmanouil</au><au>Chatziioannou, Sofia</au><au>Sipsas, Nikolaos V.</au><au>Pneumaticos, Spyridon G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparative study of heterogeneous antibiotic resistance of microbial populations in conventional periprosthetic tissue cultures and sonication fluid cultures of orthopaedics explanted prostheses</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>30</volume><issue>7</issue><spage>1307</spage><epage>1318</epage><pages>1307-1318</pages><issn>1633-8065</issn><eissn>1432-1068</eissn><abstract>Background
“Heterogeneity” describes a phenomenon where subpopulations of seemingly isogenic bacteria exhibit a range of susceptibilities to a particular antibiotic. We aim to investigate the frequency of heterogeneity among microbes isolated from infected prostheses, and its possible correlation with microbial resistance.
Methods
Between May 2014 and June 2019, we investigated 234 patients, at our institution, undergoing revision arthroplasty because of loosening of the prostheses or because of periprosthetic joint infection. All patients had periprosthetic tissue culture, sonication of prosthesis and direct inoculation of Sonication fluid into blood culture bottles. We assessed the presence of heterogeneity among all pathogens isolated from infected prostheses.
Results
Using standard non-microbiological criteria to determine periprosthetic joint infection, it was found that 143 patient (61.1%) had aseptic loosening while 91 patients (38.9%) had periprosthetic joint infection. Comparing the two methods, the results of our study showed that the method of sonication was significantly more sensitive than tissue culture [91% (83–96) vs. 43% (33–54);
p
< 0.005]. In this study, heterogeneity was reported in 15 cases, 16.5% of all infections and 6.4% in the total population. In our study,
Staphylococcus
epidermidis
was the most commonly isolated strain followed by
Staphylococcus aureus
, at a rate of 35.2% and 19.8%, respectively. Antibiotics in which the microorganisms exhibited heterogeneous bacterial behavior most frequently were Gendamicin (5.3%), Vancomycin (4.9%).
Conclusion
There is increasing evidence that heterogeneity can lead to therapeutic failure and that the detection of this phenotype is a prerequisite for a proper antibiotic choice to have a successful therapeutic effect.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>32449081</pmid><doi>10.1007/s00590-020-02704-4</doi><tpages>12</tpages></addata></record> |
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| title | A comparative study of heterogeneous antibiotic resistance of microbial populations in conventional periprosthetic tissue cultures and sonication fluid cultures of orthopaedics explanted prostheses |
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