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a routine clinical and microbiological diagnostic workup for patients with a suspected PJI. Apart from withholding antibiotic treatment prior to infection surgery, it is important that a sufficient amount of intraoperative tissue samples is obtained
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intervention. In case of tissues, multiple specimens should be taken, each with clean instruments (not superficial). In case of joint effusion near the fracture site, sterile puncture may be included as a single sample. 3 Presence of pathogens in
Porto Bone and Joint Infection Group (GRIP), Centro Hospitalar Universitário do Porto and Grupo TrofaSaude, Portugal
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Department of Microbiology, Centro Hospitalar Universitário do Porto, Porto, Portugal
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Department of Microbiology, Centro Hospitalar Universitário do Porto, Porto, Portugal
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helpful in establishing a diagnosis in doubtful cases ( Fig. 1 ). Given that most such infections will require some kind of surgical intervention, deep tissue sampling is usually considered to be the gold standard. Considering the etiopathology of
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but also what an appropriate sample is. This remains to be clarified, as samples are obtained usually from synovial fluid, sonicate fluid after implant removal, and tissues where microorganisms are suspected to be present. Considering the high cost of
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Pieve Emanuele, Milan, Italy
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Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Pieve Emanuele, Milan, Italy
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Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Pieve Emanuele, Milan, Italy
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Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Pieve Emanuele, Milan, Italy
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Department of Traumatology, Orthopaedics and Disaster Surgery, Moscow, Russia
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Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Pieve Emanuele, Milan, Italy
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Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Pieve Emanuele, Milan, Italy
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Porphyromonas and Bacteroides sp., in all samples (RA + OA). The most abundant phyla in all synovial samples:Proteobacteria,Bacteroidetes, and Firmicutes. The synovial tissue of patients with OA was mainly composed of Bacteroides , Megacoccus
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sufficient and representative tissue Take samples from the peripheral area, not central necrotic regions VIII (If possible) store small fraction of tissue fresh frozen (-80°) for research purposes Get in contact with the pathologist XI
These authors contributed equally to this manuscript
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These authors contributed equally to this manuscript
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These authors contributed equally to this manuscript
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early phase of the lesion and imaging features are not specific. For full-blown lesions, proper clinical and imaging correlation and adequate biopsy sampling are crucial in the differential diagnosis between MO and malignant soft tissue and bone tumours
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, antimicrobial treatment for the patient. Confirmation of infection Accurate microbiological diagnosis requires the analysis of representative, uncontaminated samples of tissue or fluid from the fracture. Pre-operative diagnosis from superficial swabs
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lesion. This is termed a biopsy. The label of ‘biopsy’ refers to the process of removal of the piece of tissue itself, as well as the examination of that sample by an appropriate specialist. It may be considered that biopsy itself is a simple technical
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bacteria, viruses, parasites, fungi, and human genetic material from just one sample, possibly noninvasively. There is promising data on various tissues, such as synovial fluid, blood, and cerebral spinal fluid ( 5 , 9 , 32 , 41 , 42 , 43 , 44 , 45
