Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center
Background: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasties that could occur during the surgery. The purpose of this study was to analyze the biofilm formation through microbiological culture tests and scanning electron microscopy (SEM) on the tip of surgical dra...
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MDPI AG
2024-01-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/12/3/366 |
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| author | Marco Grassi Marco Senarighi Luca Farinelli Annamaria Masucci Monica Mattioli-Belmonte Caterina Licini Antonio Gigante |
| author_facet | Marco Grassi Marco Senarighi Luca Farinelli Annamaria Masucci Monica Mattioli-Belmonte Caterina Licini Antonio Gigante |
| author_sort | Marco Grassi |
| collection | DOAJ |
| description | Background: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasties that could occur during the surgery. The purpose of this study was to analyze the biofilm formation through microbiological culture tests and scanning electron microscopy (SEM) on the tip of surgical drainage removed 24 h after arthroplasty surgery. Methods: A total of 50 consecutive patients were included in the present prospective observational study. Drains were removed under total aseptic conditions twenty-four hours after surgery. The drain tip was cut in three equal parts of approximately 2–3 cm in length and sent for culture, culture after sonication, and SEM analysis. The degree of biofilm formation was determined using a SEM semi-quantitative scale. Results: From the microbiological analysis, the cultures of four samples were positive. The semi-quantitative SEM analysis showed that no patient had grade 4 of biofilm formation. A total of 8 patients (16%) had grade 3, and 14 patients (28%) had grade 2. Grade 1, scattered cocci with immature biofilm, was contemplated in 16 patients (32%). Finally, 12 patients (24%) had grade 0 with a total absence of bacteria. During the follow-up (up to 36 months), no patient showed short- or long-term infectious complications. Conclusions: Most of the patients who underwent primary total knee arthroplasty (TKA) showed biofilm formation on the tip of surgical drain 24 h after surgery even though none showed a mature biofilm formation (grade 4). Furthermore, 8% of patients were characterized by a positivity of culture analysis. However, none of the patients included in the study showed signs of PJI up to 3 years of follow-up. |
| first_indexed | 2024-03-08T03:57:11Z |
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| language | English |
| last_indexed | 2024-03-08T03:57:11Z |
| publishDate | 2024-01-01 |
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| series | Healthcare |
| spelling | doaj.art-e9c7ec4f79d24adaa13d43fc1f51738f2024-02-09T15:12:45ZengMDPI AGHealthcare2227-90322024-01-0112336610.3390/healthcare12030366Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single CenterMarco Grassi0Marco Senarighi1Luca Farinelli2Annamaria Masucci3Monica Mattioli-Belmonte4Caterina Licini5Antonio Gigante6Clinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica Delle Marche, 60121 Ancona, ItalyClinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica Delle Marche, 60121 Ancona, ItalyClinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica Delle Marche, 60121 Ancona, ItalyLaboratory of Clinical Pathology and Microbiology, General Service Department, Azienda Ospedaliera Universitaria “Ospedali Riuniti”, 60121 Ancona, ItalyDepartment of Clinical and Molecular Sciences, Università Politecnica Delle Marche, 60121 Ancona, ItalyDepartment of Clinical and Molecular Sciences, Università Politecnica Delle Marche, 60121 Ancona, ItalyClinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica Delle Marche, 60121 Ancona, ItalyBackground: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasties that could occur during the surgery. The purpose of this study was to analyze the biofilm formation through microbiological culture tests and scanning electron microscopy (SEM) on the tip of surgical drainage removed 24 h after arthroplasty surgery. Methods: A total of 50 consecutive patients were included in the present prospective observational study. Drains were removed under total aseptic conditions twenty-four hours after surgery. The drain tip was cut in three equal parts of approximately 2–3 cm in length and sent for culture, culture after sonication, and SEM analysis. The degree of biofilm formation was determined using a SEM semi-quantitative scale. Results: From the microbiological analysis, the cultures of four samples were positive. The semi-quantitative SEM analysis showed that no patient had grade 4 of biofilm formation. A total of 8 patients (16%) had grade 3, and 14 patients (28%) had grade 2. Grade 1, scattered cocci with immature biofilm, was contemplated in 16 patients (32%). Finally, 12 patients (24%) had grade 0 with a total absence of bacteria. During the follow-up (up to 36 months), no patient showed short- or long-term infectious complications. Conclusions: Most of the patients who underwent primary total knee arthroplasty (TKA) showed biofilm formation on the tip of surgical drain 24 h after surgery even though none showed a mature biofilm formation (grade 4). Furthermore, 8% of patients were characterized by a positivity of culture analysis. However, none of the patients included in the study showed signs of PJI up to 3 years of follow-up.https://www.mdpi.com/2227-9032/12/3/366periprosthetic joint infectiontotal knee arthroplastyinfection diseasebiofilmsurgical drainage |
| spellingShingle | Marco Grassi Marco Senarighi Luca Farinelli Annamaria Masucci Monica Mattioli-Belmonte Caterina Licini Antonio Gigante Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center Healthcare periprosthetic joint infection total knee arthroplasty infection disease biofilm surgical drainage |
| title | Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center |
| title_full | Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center |
| title_fullStr | Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center |
| title_full_unstemmed | Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center |
| title_short | Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center |
| title_sort | early biofilm formation on the drain tip after total knee arthroplasty is not associated with prosthetic joint infection a pilot prospective case series study of a single center |
| topic | periprosthetic joint infection total knee arthroplasty infection disease biofilm surgical drainage |
| url | https://www.mdpi.com/2227-9032/12/3/366 |
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