Diagnostic Contribution of Blood Culture Bottle Inoculation for Joint and Periprosthetic Fluid Samples: Relationship with Pathogen Spectrum and Clinical Features
Indian Journal of Orthopaedics, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s43465-026-02001-y
- Dergi Adı: Indian Journal of Orthopaedics
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Blood culture bottle, Coagulase-negative staphylococci, Diagnostic sensitivity, Prosthetic joint infection, Septic arthritis, Staphylococcus aureus
- Sivas Cumhuriyet Üniversitesi Adresli: Evet
Özet
Background: This study aimed to assess the diagnostic contribution of incorporating the blood culture bottle (BCB) method into conventional agar-based cultures for identifying joint and periprosthetic infections, and to evaluate its impact on pathogen distribution and clinical subgroups. Methods: Eighty-seven patients with microbial growth detected in BCBs from joint or periprosthetic fluid samples between January 2017–June 2025 were retrospectively analyzed. Patients were classified into two groups based on synovial-agar-culture results: both BCB and agar positive (Group 1, n = 61) and BCB positive only (Group 2, n = 26). Clinical, laboratory, and microbiological findings were compared, and subgroup analyses were conducted for prosthetic versus native joint infections and for hip versus knee prosthetic infections. Results: Growth was detected exclusively in BCBs in 29.9% of cases. Staphylococcus aureus was the most frequently isolated pathogen (45.9%), followed by coagulase-negative staphylococci (13.8%) and Streptococcus spp. (10.3%). Coagulase-negative staphylococci were significantly more common in BCB-only cases (p<0.001), which also showed substantially lower synovial leukocyte counts (p <0.001). Hip prosthesis presence was more common in this group (p = 0.021). Compared with native joint infections, prosthetic joint infection cases were older (p <0.001), predominantly female (p = 0.026), and had a higher rate of Gram-negative pathogens (p = 0.048). S. aureus was significantly more frequent in knee prosthesis infections (p = 0.014). Conclusion: The BCB method provides a measurable diagnostic advantage when added to agar-based cultures. Its added sensitivity is particularly evident in cases involving coagulase-negative staphylococci, low synovial leukocyte levels, and hip prostheses. Incorporating BCB inoculation into routine diagnostic workflows may improve the detection of culture-negative joint infections and support timely antimicrobial and surgical management.