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Henssler, Leopold ; Schellenberger, Lena ; Baertl, Susanne ; Klute, Lisa ; Heyd, Robert ; Kerschbaum, Maximilian ; Alt, Volker ; Popp, Daniel

Time to Positivity in Blood Culture Bottles Inoculated with Sonication Fluid from Fracture-Related Infections

Henssler, Leopold, Schellenberger, Lena, Baertl, Susanne , Klute, Lisa, Heyd, Robert, Kerschbaum, Maximilian , Alt, Volker and Popp, Daniel (2024) Time to Positivity in Blood Culture Bottles Inoculated with Sonication Fluid from Fracture-Related Infections. Microorganisms 12 (5), p. 862.

Date of publication of this fulltext: 10 May 2024 14:52
Article
DOI to cite this document: 10.5283/epub.58225


Abstract

The timely and accurate identification of causative agents is crucial for effectively managing fracture-related infections (FRIs). Among various diagnostic methods, the “time to positivity” (TTP) of cultures has emerged as a valuable predictive factor in infectious diseases. While sonication of implants and inoculation of blood culture bottles with sonication fluid have enhanced sensitivity, data ...

The timely and accurate identification of causative agents is crucial for effectively managing fracture-related infections (FRIs). Among various diagnostic methods, the “time to positivity” (TTP) of cultures has emerged as a valuable predictive factor in infectious diseases. While sonication of implants and inoculation of blood culture bottles with sonication fluid have enhanced sensitivity, data on the TTP of this microbiological technique remain limited. Therefore, patients with ICM criteria for confirmed FRI treated at our institution between March 2019 and March 2023 were retrospectively identified and their microbiological records were analyzed. The primary outcome parameter was TTP for different microorganism species cultured in a liquid culture collected from patients with confirmed FRI. A total of 155 sonication fluid samples from 126 patients (average age 57.0 ± 17.4 years, 68.3% males) was analyzed. Positive bacterial detection was observed in 78.7% (122/155) of the liquid culture pairs infused with sonication fluid. Staphylococcus aureus was the most prevalent organism (42.6%). Streptococcus species exhibited the fastest TTP (median 11.9 h), followed by Staphylococcus aureus (median 12.1 h) and Gram-negative bacteria (median 12.5 h), all of which had a 100% detection rate within 48 h after inoculation. Since all Gram-negative pathogens yielded positive culture results within 24 h, it could be discussed if empirical antibiotic therapy could be de-escalated early and limited towards the Gram-positive germ spectrum if no Gram-negative pathogens are detected up to this time point in the context of antibiotic stewardship.



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Details

Item typeArticle
Journal or Publication TitleMicroorganisms
Publisher:MDPI
Volume:12
Number of Issue or Book Chapter:5
Page Range:p. 862
Date26 April 2024
InstitutionsMedicine > Lehrstuhl für Unfallchirurgie
Identification Number
ValueType
10.3390/microorganisms12050862DOI
Keywordssonication; fracture-related infections; time to positivity; microbiology; diagnostics; antibiotic stewardship; bacteria
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgYes
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-582259
Item ID58225

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