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Journal of Clinical Microbiology, June 2009, p. 1878-1884, Vol. 47, No. 6
0095-1137/09/$08.00+0     doi:10.1128/JCM.01686-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Microbiologic Diagnosis of Prosthetic Shoulder Infection by Use of Implant Sonication{triangledown}

Kerryl E. Piper,1 Melissa J. Jacobson,1 Robert H. Cofield,2 John W. Sperling,2 Joaquin Sanchez-Sotelo,2 Douglas R. Osmon,1 Andrew McDowell,5 Sheila Patrick,5 James M. Steckelberg,1 Jayawant N. Mandrekar,3 Marta Fernandez Sampedro,1 and Robin Patel1,4*

Division of Infectious Diseases, Department of Medicine,1 Department of Orthopedic Surgery,2 Division of Biostatistics,3 Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota,4 Center for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom5

Received 29 August 2008/ Returned for modification 12 October 2008/ Accepted 21 February 2009

We recently described a sonication technique for the diagnosis of prosthetic knee and hip infections. We compared periprosthetic tissue culture to implant sonication followed by sonicate fluid culture for the diagnosis of prosthetic shoulder infection. One hundred thirty-six patients undergoing arthroplasty revision or resection were studied; 33 had definite prosthetic shoulder infections and 2 had probable prosthetic shoulder infections. Sonicate fluid culture was more sensitive than periprosthetic tissue culture for the detection of definite prosthetic shoulder infection (66.7 and 54.5%, respectively; P = 0.046). The specificities were similar (98.0% and 95.1%, respectively; P = 0.26). Propionibacterium acnes was the commonest species detected among culture-positive definite prosthetic shoulder infection cases by periprosthetic tissue culture (38.9%) and sonicate fluid culture (40.9%). All subjects from whom P. acnes was isolated from sonicate fluid were male. We conclude that sonicate fluid culture is useful for the diagnosis of prosthetic shoulder infection.

* Corresponding author. Mailing address: Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, 200 First St. S.W., Rochester, MN 55905. Phone: (507) 538-0579. Fax: (507) 284-4272. E-mail: patel.robin{at}mayo.edu

{triangledown} Published ahead of print on 4 March 2009.

Journal of Clinical Microbiology, June 2009, p. 1878-1884, Vol. 47, No. 6
0095-1137/09/$08.00+0     doi:10.1128/JCM.01686-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Del Pozo, J. L., Patel, R. (2009). Infection Associated with Prosthetic Joints. NEJM 361: 787-794 [Full Text]  


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