Heraeus MicroDTTect Lyon Pilot Studyprosthetic Joint Infections (PJIs)

Hospices Civils de Lyon20 enrolled

Overview

Prosthetic joint infections (PJIs) are one of the main causes of implant failure after joint arthroplasty. Identification of the causal organism is crucial for successful treatment. However, microbiological diagnosis of PJIs remains a challenge notably because bacteria are embedded in biofilm adhered to the material. Recently, dithiothreitol (DTT) treatment of prosthesis has been proposed as a new strategy to dislodge bacteria from biofilm, thus becoming an alternative to sonication to improve the yield of the microbiological diagnosis. In this study, the investigators evaluate the interest of a commercial device using DTT, the MicroDTTect system (Heraeus, Hanau, Allemagne), for the diagnosis of low-grade chronic PJIs compared to the conventional culture of periprosthetic tissue (PPT) samples.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Chronic PJIs

Interventions

No specific or supplementary intervention is performed among patients. The included patients have scheduled surgery consisting of prosthesis removal or change. Instead of being discarded, the prosthesis which was removed during the surgery was sent to the laboratory using the MicroDTTect system and bacterial culture was performed with the fluid obtained. Results will be then compared to classical culture of periprosthetic tissues (PPT).

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Adult patients with painful prosthesis or prosthesis loosening \<10 years * without mechanical explanation, * without clinical evidence of infection (no fistula, no abscess, no discharge, no local inflammation), * without microbiological diagnosis (absence of preoperative joint puncture (not performed or not feasible) or with a culture-negative preoperative joint puncture). Exclusion Criteria: Patients with painful prosthesis or prosthesis loosening * with mechanical explanation, * or with clinical evidence of infection (fistula, abscess, discharge, local inflammation), * with a previous microbiological diagnosis

Outcomes

Primary Outcomes

Rate of bacteria isolated isolated

type of bacteria isolated

Time frame: every day until 15 days of culture

Secondary Outcomes

time to positivity of cultures

time to positivity of cultures of the fluid obtained after prosthesis treatment using the MicroDTTect system in comparison with conventional culture of PPT samples