Summary of recommended microbiological diagnostic methods by implant type
| Implant type | Essential tests | Special situation test | Additional tests for negative tests results | Not recommended |
|---|---|---|---|---|
| Prosthetic joints | • Synovial fluid culture in blood culture bottles (aerobic and anaerobic) • 3-4 separate tissue specimens for culture (3 if using blood culture bottles, 4 if using standard culture) |
• Extended anaerobic culture for 14 days when chronic infection or • Sonication culture of removed implants • Consider fungal/mycobacterial cultures in specific circumstances |
• Molecular diagnostics for culture-negative cases | • Tissue/synovial fluid/sonicate fluid Gram stain • Swab cultures • Sinus tract cultures |
| Cardiac implants | • Minimum 2 sets of blood cultures (aerobic and anaerobic) • For prosthetic vascular grafts: at least 3 tissue specimens for culture • For CIED infections: pocket tissue cultures and sonication of removed device |
For culture-negative PVE: • • Valve tissue pathology and Gram stain • 16S rRNA gene PCR/sequencing when pathogen undefined |
• Sinus tract cultures | |
| Intravascular catheters | • Minimum 2 sets of blood cultures (one peripheral, one through catheter) if DTP will be calculated • DTP >2 hours suggests catheter-related infection • Consider quantitative blood cultures |
• Catheter tip cultures [46] | ||
| Neurosurgical implants | • 2 sets of blood cultures (especially for VA shunt infections and meningitis) • CSF culture (before antibiotics if possible) |
• Extended anaerobic culture for |
• Consider molecular testing in culture-negative cases | • Routine culture of removed shunts/drains without clinical suspicion |
| Urologic implants | • Culture only if symptomatic • Midstream urine after catheter removal or from sampling port of newly inserted catheter |
• Pyuria alone not diagnostic | ||
| Gastrointestinal implants | • Gram stain and culture of aspirate from suspected mesh infections | • Fungal/mycobacterial cultures in specific circumstances | • PEG exit site swab cultures • Explanted biliary stent cultures |
Korean J healthc assoc Infect Control Prev 2024;29:93~102 https://doi.org/10.14192/kjicp.2024.29.2.93
© Korean J healthc assoc Infect Control Prev