A More Positive Culture by Resin-containing Media Usage after Suspicious Arthroscopic Infections in Patients Receiving Antimicrobial Therapy

Document Type : RESEARCH PAPER

Authors

1 Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

2 Tehran University of Medical Sciences, knee and hip surgeon, Department of Orthopedic Surgery, Imam Khomaini Hospital, Tehran, Iran

3 Tehran University of Medical Sciences, knee surgeon, Department of Orthopedic Surgery, Shariati Hospital, Tehran, Iran

4 Orthopaedic surgeon, bone and joint reconstruction research center, University of Medical Sciences, Department of Orthopedic Surgery, Shafa Yahyaiyan Hospital, Tehran, Iran

Abstract

Background: Although infections following arthroscopic surgery of cruciate ligament and meniscus are uncommon,
they have potentially serious consequences for the graft and articular cartilage. This study aimed to investigate
the efficacy of correct sampling and appropriate media, especially resin-containing media, for the detection of
infections in patients receiving antibiotics under suspicion of joint infection after arthroscopic anterior cruciate
ligament (ACL) and meniscal surgery. In such cases, proper sampling and the use of suitable culture media that
cause the neutralization of antibiotics are very effective in isolating microorganisms from the patient samples and
positive cultures.
Methods: In total, 10 patients who had received antibiotics with suspected knee infection after arthroscopic ACL
and meniscal surgery were identified after referral to surgeons during a period of 10 months and investigated in this
study. The sample collection, culture on various media (i.e., resin-containing culture media), microbiological tests,
and antibiotic susceptibility tests were performed in this study. The amplification of the mecA gene using PCR assay
was accomplished for methicillin-resistant staphylococcus strains.
Results: This study was conducted on 10 patients who underwent arthroscopic procedures and had received
antibiotics. Overall, joint fluid and tissue culture were positive in 60% of the patients. The resin-containing media
revealed a trend toward increased detection of bacteria. Coagulase-negative staphylococcus strains were the most
frequently isolated bacteria in arthroscopic ACL surgery infections. Out of five methicillin-resistant staphylococcus
strains, four strains were found that were resistant to cefoxitin and positive-mecA designated as methicillin-resistant
strains. Except for one case, the rest of the staphylococcal strains were resistant to methicillin but susceptible to
vancomycin.
Conclusion: Despite uncommon and low percentage of infections after arthroscopic ACL and meniscal surgery,
the results of our study showed that correct sampling, appropriate cultures, especially aerobic and anaerobic resincontaining
media, and microbiological testing remained useful and valuable for diagnosing bacterial infections.
Level of evidence: II

Keywords

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The Archives of Bone and Joint Surgery
Volume 9, Issue 5
September and October 2021
Pages 496-502

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History

  • Receive Date: 08 September 2020
  • Revise Date: 16 October 2020
  • Accept Date: 30 November 2020

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