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Abstract：
BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasties that could occur during the surgery. The purpose of this study was to analyze the biofilm formation through microbiological culture tests and scanning electron microscopy (SEM) on the tip of surgical drainage removed 24 h after arthroplasty surgery.
METHODS: A total of 50 consecutive patients were included in the present prospective observational study. Drains were removed under total aseptic conditions twenty-four hours after surgery. The drain tip was cut in three equal parts of approximately 2-3 cm in length and sent for culture, culture after sonication, and SEM analysis. The degree of biofilm formation was determined using a SEM semi-quantitative scale.
RESULTS: From the microbiological analysis, the cultures of four samples were positive. The semi-quantitative SEM analysis showed that no patient had grade 4 of biofilm formation. A total of 8 patients (16%) had grade 3, and 14 patients (28%) had grade 2. Grade 1, scattered cocci with immature biofilm, was contemplated in 16 patients (32%). Finally, 12 patients (24%) had grade 0 with a total absence of bacteria. During the follow-up (up to 36 months), no patient showed short- or long-term infectious complications.
CONCLUSIONS: Most of the patients who underwent primary total knee arthroplasty (TKA) showed biofilm formation on the tip of surgical drain 24 h after surgery even though none showed a mature biofilm formation (grade 4). Furthermore, 8% of patients were characterized by a positivity of culture analysis. However, none of the patients included in the study showed signs of PJI up to 3 years of follow-up.
METHODS: A total of 50 consecutive patients were included in the present prospective observational study. Drains were removed under total aseptic conditions twenty-four hours after surgery. The drain tip was cut in three equal parts of approximately 2-3 cm in length and sent for culture, culture after sonication, and SEM analysis. The degree of biofilm formation was determined using a SEM semi-quantitative scale.
RESULTS: From the microbiological analysis, the cultures of four samples were positive. The semi-quantitative SEM analysis showed that no patient had grade 4 of biofilm formation. A total of 8 patients (16%) had grade 3, and 14 patients (28%) had grade 2. Grade 1, scattered cocci with immature biofilm, was contemplated in 16 patients (32%). Finally, 12 patients (24%) had grade 0 with a total absence of bacteria. During the follow-up (up to 36 months), no patient showed short- or long-term infectious complications.
CONCLUSIONS: Most of the patients who underwent primary total knee arthroplasty (TKA) showed biofilm formation on the tip of surgical drain 24 h after surgery even though none showed a mature biofilm formation (grade 4). Furthermore, 8% of patients were characterized by a positivity of culture analysis. However, none of the patients included in the study showed signs of PJI up to 3 years of follow-up.
摘要：
背景：假体周围关节感染（PJI）是手术期间可能发生的关节置换术的破坏性并发症。这项研究的目的是通过微生物培养测试和扫描电子显微镜（SEM）分析生物膜的形成在关节成形术手术后24h去除的手术引流尖端。
方法：本前瞻性观察研究共纳入50例连续患者。在手术后24小时,在完全无菌条件下除去排水管。将排水尖端切成三个相等的部分，长度约为2-3厘米，然后送去培养。超声处理后的培养，和SEM分析。使用SEM半定量标度确定生物膜形成的程度。
结果：从微生物学分析，4个样本的培养均为阳性.半定量SEM分析显示,没有患者具有4级生物膜形成。共有8名患者（16％）为3级，14名患者（28％）为2级。1级，散落球菌有未成熟生物膜，在16例患者（32%）中考虑。最后,12名患者（24％）为0级，完全没有细菌。在随访期间（长达36个月），无患者出现短期或长期感染并发症.
结论：大多数接受初次全膝关节置换术（TKA）的患者在手术后24小时在手术引流管尖端显示生物膜形成，尽管没有人显示成熟的生物膜形成（4级）。此外，8%的患者的特征是培养分析阳性。然而,研究中纳入的患者在随访3年后均未出现PJI征象.
方法：本前瞻性观察研究共纳入50例连续患者。在手术后24小时,在完全无菌条件下除去排水管。将排水尖端切成三个相等的部分，长度约为2-3厘米，然后送去培养。超声处理后的培养，和SEM分析。使用SEM半定量标度确定生物膜形成的程度。
结果：从微生物学分析，4个样本的培养均为阳性.半定量SEM分析显示,没有患者具有4级生物膜形成。共有8名患者（16％）为3级，14名患者（28％）为2级。1级，散落球菌有未成熟生物膜，在16例患者（32%）中考虑。最后,12名患者（24％）为0级，完全没有细菌。在随访期间（长达36个月），无患者出现短期或长期感染并发症.
结论：大多数接受初次全膝关节置换术（TKA）的患者在手术后24小时在手术引流管尖端显示生物膜形成，尽管没有人显示成熟的生物膜形成（4级）。此外，8%的患者的特征是培养分析阳性。然而,研究中纳入的患者在随访3年后均未出现PJI征象.
