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Peking University First Hospital Procedure for Culturing Pathogenic Microorganisms for Bone and Joint Infection
Yunpeng Cui1, Qiwei Wang1, Chuan Mi1
1Department of Orthopaedics, Peking University First Hospital, Beijing, People's Republic of China.
Background:
This retrospective cohort study explores a practical approach to acquiring pathogenic microorganisms in patients with bone and joint infections.
Methods:
From Aug 2018 to Mar 2022, 68 consecutive patients (87 cultures) with bone and joint infection were recruited in this study. All cultures followed the Peking University First Hospital Procedure of Culturing Pathogenic microorganisms for bone and joint infection. Tissue samples were obtained through fluoroscopy-guided biopsy or open debridement. Tissue samples were divided into manual homogenization (MH), manual mixture (MM), and pathological examination. The baseline, antibiotic exposure, laboratory, surgical, and microbial data were reviewed. Independent sample T-test, Mann-Whitney U-test, and Chi-square test were used to detect the difference between patients who received different processing measures.
Results:
The average age was 55.8±2.4 years old. Thirty-nine patients were male. The total positive culture rate of the manual homogenization group was 80.5% (70/87). Thirty-five patients had mixed infections with more than one microorganism cultured. Staphylococci accounted for 60.23% of all microorganisms. Staphylococcus aureus (18.2%) and Staphylococcus epidermidis (15.9%) were the two most common bacteria cultured in this study. Patients with positive culture in the manual mixture group had significantly higher WBC (p = 0.006), NE% (p = 0.024), ESR (p = 0.003), CRP (p = 0.020) and IL6 (0.050) compared to patients with negative culture. After tissue homogenization, only ESR is still statistically different. Patients without SIRS had a low positive culture rate (59.4%). Tissue homogenization could significantly increase the positive culture rate of patients without SIRS. Pre-culture antibiotic exposure was not an independent risk factor for culture results.
Conclusion:
Peking University First Hospital Procedure for Culturing Pathogenic microorganisms for Bone and Joint Infections was a practical approach for obtaining pathogenic microorganisms.
Insights
This study found that tissue homogenization significantly improves pathogen detection rates in bone and joint infections, especially in patients without systemic inflammatory response syndrome. The Peking University First Hospital Procedure is a practical method for identifying microorganisms.
Area of Science:
- Infectious Diseases
- Microbiology
- Orthopedic Surgery
Background:
- Bone and joint infections (BJIs) pose significant diagnostic challenges.
- Accurate identification of pathogenic microorganisms is crucial for effective treatment.
- Current methods for pathogen acquisition in BJIs require optimization.
Purpose of the Study:
- To evaluate the effectiveness of the Peking University First Hospital Procedure for culturing pathogenic microorganisms in patients with BJIs.
- To compare different tissue sample processing methods for optimizing pathogen detection.
- To identify factors influencing the positive culture rate in BJIs.
Main Methods:
- A retrospective cohort study of 68 patients with BJIs from Aug 2018 to Mar 2022.
- Tissue samples were processed using manual homogenization (MH), manual mixture (MM), or pathological examination.
- Microbial data, clinical information, and laboratory results were analyzed using statistical tests.
Main Results:
- The manual homogenization group achieved an 80.5% positive culture rate.
- Patients with positive cultures in the manual mixture group showed elevated inflammatory markers (WBC, NE%, ESR, CRP, IL6).
- Tissue homogenization significantly increased positive culture rates in patients without SIRS and was the only method maintaining statistical difference in ESR post-processing.
Conclusions:
- The Peking University First Hospital Procedure is a practical and effective approach for acquiring pathogenic microorganisms in BJIs.
- Tissue homogenization is a key step for improving diagnostic yield, particularly in specific patient subgroups.
- Pre-culture antibiotic exposure did not independently affect culture outcomes.
