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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 4, issue 3
J. Bone Joint Infect., 4, 120–125, 2019
https://doi.org/10.7150/jbji.32975
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 4, 120–125, 2019
https://doi.org/10.7150/jbji.32975
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.

Original full-length article 21 May 2019

Original full-length article | 21 May 2019

The Journey of Cultures Taken During Revision Joint Arthroplasty: Preanalytical Phase

Kier M. Blevins, Karan Goswami, and Javad Parvizi Kier M. Blevins et al.
  • Rothman Institute at Thomas Jefferson University, Philadelphia, PA 19017

Keywords: culture processing, timing, revision arthroplasty, hip, knee

Abstract. Background: Microbiological culture has been considered the standard for pathogen identification for decades. However, culture is a laborious, time consuming, imperfect and outdated process. This study aims to inform the orthopedic community of the steps and timing of routine culture processing.

Methods: We prospectively tracked 103 cultures from 33 revision hip and knee arthroplasty patients between September 2017-February 2018. Times were recorded at intraoperative collection; time of pick up from OR, transportation time; arrival at the laboratory; culture processing and plating time; and time to final result reporting.

Results: Of the 103 cultures, 45.6% were processed and incubated in less than two hours, and 54.4% greater than or equal to two hours. The mean time spent in the OR, during transport, and within the laboratory prior to incubation was 0:53, 0:06 and 1:12. The range of time that samples remained at each stage varied considerably in the OR (0:03-3:33), in transit(0:04-0:16), and in the lab prior to incubation(0:26-3:01). The proportion of the total time to incubation attributed to idle time samples spent in the OR after initial sampling was 40.0%. In contrast, transport to the laboratory represented 5.1% of the total time. Idle time in the laboratory represented the greatest share at 54.9%.

Conclusion: There is significant variability in the time to transport, process and incubate culture samples. Almost half of the specimens were processed outside the 2-hour recommended window. Surgeons should be aware of idle time during processing and seek to optimize their institutional pathways to maximize culture yield.

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