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Suction drainage fluid culture during septic orthopaedic surgery, a retrospective study

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Abstract

We evaluated the usefulness of suction drainage fluid culture after septic orthopaedic surgery to predict early surgical reintervention. We conducted a retrospective observational study, at the Groupe Hospitalier Paris Saint-Joseph between 2014 and 2019. All the patients undergoing septic orthopaedic surgery, with perioperative samples and a postoperative suction drainage device, were enrolled. We compared the group with positive or negative postoperative drainage fluid cultures, respectively, on surgical outcome. We included 246 patients. The drainage fluid culture was positive in 42.3% of the cases. Early surgical reintervention concerned 14.6% of the cases (n = 36), including 61.1% of patients with positive drainage fluid culture (n = 22/36). The risk factors associated with positive drainage fluid cultures were the debridement of the infected site (without orthopaedic device removal), an infection located at the spine, perioperative positive cultures to Staphylococcus aureus. The complete change of the orthopaedic device, and coagulase-negative staphylococci on the preoperative samples, was associated with negative drainage fluid cultures. Positive drainage fluid culture was predictive of early surgical reintervention, and coagulase-negative staphylococci in the preoperative samples and knee infection were predictive of surgical success. Postoperative drainage fluid cultures were predictive of early surgical reintervention. Randomized multicentric studies should be further conducted.

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Notes

  1. https://www.eucast.org/ast_of_bacteria/

Abbreviations

PJIs:

Periprosthetic joint infections

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Acknowledgements

We thank Professor L. Bernard and Dr. A. Lemaignen for their support and careful rereading of our work.

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Authors and Affiliations

  1. Équipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France

    C.-A. Hobson, C. Couzigou & Benoit Pilmis

  2. Inserm U1137, Faculté de Médecine, IAME, Université de Paris, Site Xavier Bichat, 75018, Paris, France

    C.-A. Hobson

  3. Laboratoire de Microbiologie Clinique Et Plateforme de Dosage Des Anti-Infectieux, Groupe Hospitalier Paris Saint Joseph, 75014, Paris, France

    J. Lourtet-Hascoët, A. Mizrahi, N. El Helali & A. Le Monnier

  4. Service de Chirurgie Orthopédique, Groupe Hospitalier Paris Saint Joseph, 75014, Paris, France

    A. Mohamed Hadj, R. Courseau, G. Riouallon, F. Boillot & P. Jouffroy

  5. Université Paris-Saclay, INRAE, AgroParisTech, Institut MIcalis, 92290, Chatenay-Malabry, France

    A. Le Monnier & Benoit Pilmis

Authors
  1. C.-A. Hobson
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  2. J. Lourtet-Hascoët
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  12. Benoit Pilmis
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Correspondence to Benoit Pilmis.

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Hobson, CA., Lourtet-Hascoët, J., Mizrahi, A. et al. Suction drainage fluid culture during septic orthopaedic surgery, a retrospective study. Eur J Clin Microbiol Infect Dis 41, 641–647 (2022). https://doi.org/10.1007/s10096-022-04405-8

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  • DOI: https://doi.org/10.1007/s10096-022-04405-8

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