Periprosthetic Joint Infection with Negative Culture Results: Clinical Characteristics and Treatment Outcome

• Published in: The Journal of arthroplasty Vol. 28; no. 6; pp. 899 - 903
• Main Authors: Choi, Ho-Rim, MD, Kwon, Young-Min, MD, PhD, Freiberg, Andrew A., MD, Nelson, Sandra B., MD, Malchau, Henrik, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2013
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Knee - adverse effects; clinical characteristics; False Negative Reactions; Female; Humans; Male; Middle Aged; negative culture result; Orthopedics; periprosthetic joint infection; Prospective Studies; Prosthesis-Related Infections - diagnosis; Prosthesis-Related Infections - etiology; Prosthesis-Related Infections - microbiology; Prosthesis-Related Infections - therapy; Treatment Outcome; treatment outcomes; periprosthetic joint infection; treatment outcomes; negative culture result; clinical characteristics
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2012.10.022

Abstract Negative culture result is frequently encountered in periprosthetic joint infection, but its clinical feature has not been well studied. In this study, clinical characteristics and treatment outcome were compared in two patient groups: (1) 40 periprosthetic joint infections with negative culture results (culture-negative group) and (2) 135 patients with positive culture results (culture-positive group). In comparison of two groups, the culture-negative group showed significantly higher incidence of prior antibiotic use ( p = 0.005), higher incidence of prior resection surgery ( p < 0.001) and lower ESR ( p = 0.02) than the culture-positive group. The success rate of infection control was higher in the culture-negative group ( p = 0.006), which suggests that culture negativity may not necessarily be a negative prognostic factor for periprosthetic joint infection.