gms | German Medical Science

Objectives: Prosthetic implants, periprosthetic and osteoarticular tissues are specimens of choice for diagnosis of bone and joint infections. Homogenization is considered the best procedure for treatment of tissues samples, but it is quite laborious, time-consuming and not always performed in all laboratories. Dithiothreitol has been proposed as an alternative treatment to sonication for microbiological diagnosis of prosthetic joint infections. In this study, the applicability of dithiothreitol treatment for the processing of periprosthetic and osteoarticular tissues samples for the diagnosis of bone and joint infections was evaluated and compared to normal saline solution treatment.

Methods: Tissue samples were collected from 50 patients (17 infected and 33 non infected). For each patient, two samples from the same site were collected. One was treated with DTT (0.1% w:v) and the other with normal saline. After mechanical stirring for 15 min, samples were centrifuged at 3000 rpm for 10 min, the supernatant was discharged and aliquots of the pellet were plated on agar plates and inoculated in broths. Sensitivity and specificity were calculated for each treatment.

Results: Microbial growth was observed in samples from 14 and 11 infected patients after dithiothreitol and saline treatments, respectively. Concordance between the two methods was observed in the 85.4% of cases.

Sensitivity was 82.4% for dithiothreitol and 64.7% for saline. Specificity was 97.0% and 90.9% for dithiothreitol and saline, respectively. Treatment with dithiothreitol showed higher sensitivity and specificity in respect to the method routinely used in our laboratory.

Conclusions: Dithiothreitol treatment may be considered a practicable strategy for microbiological analysis of tissues for diagnosis of bone and joint infections, being simple to use and not requiring dedicated instrumentation.