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Microbiological Diagnosis of Implant-Related Infections: Scientific Evidence and Cost/Benefit Analysis of Routine Antibiofilm Processing

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A Modern Approach to Biofilm-Related Orthopaedic Implant Infections

Part of the book series: Advances in Experimental Medicine and Biology ((AMIDPH,volume 971))

Abstract

Prosthetic joint infection is one of the most severe complication following joint arthroplasty, producing a significant worsening of patient’s quality of life. Management of PJIs requires extended courses of antimicrobial therapy, multiple surgical interventions and prolonged hospital stay, with a consequent economic burden, which is thought to markedly increase in the next years due to the expected burden in total joint arthroplasties. The present review summarizes the present knowledge on microbiological diagnosis of prosthetic joint infections, focusing on aethiological agents and discussing pros and cons of the available strategies for their diagnosis.

Intra-operative clinical diagnosis and pathogen identification is considered the diagnostic benchmark, however the presence of bacterial biofilm makes pathogen detection with traditional microbiological techniques highly ineffective. Diagnosis of PJIs is a rather complex challenge for orthopedics and requires a strict collaboration between different specialists: orthopaedics, infectivologists, microbiologists, pathologists and radiologists. Diagnostic criteria have been described by national and international association and scientific societies. Clinicians should be trained on how to use it, but more importantly they should know potential and limitation of the available tests in order to use them appropriately.

The original version of this chapter has been revised. An erratum to this chapter can be found at DOI 10.1007/5584_2017_21

An erratum to this chapter can be found at http://dx.doi.org/10.1007/5584_2017_21

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  1. Laboratory of Clinical-Chemistry and Microbiology, IRCCS Galeazzi Institute, Milan, Italy

    Lorenzo Drago & Elena De Vecchi

  2. Department of Biomedical Science for Health, University of Milan, Milan, Italy

    Lorenzo Drago

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    Lorenzo Drago

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Drago, L., De Vecchi, E. (2016). Microbiological Diagnosis of Implant-Related Infections: Scientific Evidence and Cost/Benefit Analysis of Routine Antibiofilm Processing. In: Drago, L. (eds) A Modern Approach to Biofilm-Related Orthopaedic Implant Infections. Advances in Experimental Medicine and Biology(), vol 971. Springer, Cham. https://doi.org/10.1007/5584_2016_154

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