Microbiological Diagnosis of Prosthetic Joint Infections

Prosthetic joint infections (PJI) are the most important complication of joint replacement surgery. Diagnosis of PJI should be made with a multidisciplinary approach. Microbiological diagnostic methods must be used to isolate the causative microorganisms and to determine the antimicrobial susceptibility of these microorganisms. Microbiological methods used in preoperative diagnosis are blood culture, leukocyte count and type in synovial fluid and culture of synovial fluid. Those used in intraoperative diagnosis are cultures of abscesses, synovial fluid, soft tissue and bones located in and around prosthesis taken during the surgery. Other microbiological methods used in diagnosis of Pi's are microcalorimetry, matrix assisted lazer desorption/ionization-time of flight mass spectrometry, homogenization of tissue samples with glass beads, fluorescent in situ hybridization, synovial biomarkers, enzymatic template generation and amplification. Also, various molecular methods such as 16S rRNA sequencing analysis and polymerase chain reaction methods can be used for diagnosis of PJI. The aim of this review was to discuss the microbiological diagnostic methods of PJI in the light of current literatures.