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Unexpected Bacteriological Finding Using Sonication in Revision Spine Surgery (Report of Two Cases)
Matias L Cullari1, Santiago A Aguer1, Ruy Lloyd1
1Orthopedic Surgery British Hospital, Buenos Aires, Argentina.
Abstract:
The number of spine surgeries around the world is increasing in recent years. Each time, new techniques and minimal invasive procedures are developing. However, the incidence of postoperative spinal infections (PSII) ranges from 0.7% to 20%. In cases of infection, identification of the pathogen is essential to apply the appropriate antimicrobial treatment. Most of the usual techniques are based on the recovery of samples from the periprosthetic tissue followed by inoculation in culture media. In the last years, the presence of biofilm-forming bacteria has increased, which has the ability to decrease the sensitivity of the traditional culture method. The application of sonication prior to culture on the rescued inert material, disrupts the biofilm and generates a significantly higher recovery of bacterial growth compared to conventional tissue culture. We present a case series from our service of patients undergoing apparently aseptic lumbar spine revision surgery with positive culture by sonication.
Insights
Sonication before bacterial culture significantly improves pathogen detection in postoperative spinal infections (PSII). This method is crucial for identifying biofilm-forming bacteria, enhancing antimicrobial treatment effectiveness.
Area of Science:
- Spinal surgery
- Infectious diseases
- Microbiology
Background:
- Spine surgeries are increasing globally, with postoperative spinal infections (PSII) occurring in 0.7%–20% of cases.
- Accurate pathogen identification is vital for effective antimicrobial treatment of PSII.
- Biofilm-forming bacteria complicate traditional culture methods, reducing diagnostic sensitivity.
Observation:
- A case series involving patients undergoing lumbar spine revision surgery with initially aseptic findings is presented.
- Sonication of inert material prior to culture was employed.
- This technique aims to disrupt biofilms and improve bacterial recovery.
Findings:
- Sonication effectively disrupts bacterial biofilms on inert materials.
- This method significantly increases bacterial recovery compared to conventional tissue culture.
- Positive cultures were obtained in patients with initially aseptic lumbar spine revision surgery.
Implications:
- Sonication-assisted culture offers a more sensitive diagnostic approach for PSII.
- Improved pathogen detection can lead to more targeted and effective antimicrobial therapies.
- This technique may be particularly valuable in cases involving suspected biofilm formation.
