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Abstract：
Addressing the existing problem in the microbiological diagnosis of infections associated with implants and the current debate about the real power of precision of sonicated fluid culture (SFC), the objective of this review is to describe the methodology and analyze and compare the results obtained in current studies on the subject. Furthermore, the present study also discusses and suggests the best parameters for performing sonication. A search was carried out for recent studies in the literature (2019-2023) that addressed this research topic. As a result, different sonication protocols were adopted in the studies analyzed, as expected, and consequently, there was significant variability between the results obtained regarding the sensitivity and specificity of the technique in relation to the traditional culture method (periprosthetic tissue culture - PTC). Coagulase-negative Staphylococcus (CoNS) and Staphylococcus aureus were identified as the main etiological agents by SFC and PTC, with SFC being important for the identification of pathogens of low virulence that are difficult to detect. Compared to chemical biofilm displacement methods, EDTA and DTT, SFC also produced variable results. In this context, this review provided an overview of the most current scenarios on the topic and theoretical support to improve sonication performance, especially with regard to sensitivity and specificity, by scoring the best parameters from various aspects, including sample collection, storage conditions, cultivation methods, microorganism identification techniques (both phenotypic and molecular) and the cutoff point for colony forming unit (CFU) counts. This study demonstrated the need for standardization of the technique and provided a theoretical basis for a sonication protocol that aims to achieve the highest levels of sensitivity and specificity for the reliable microbiological diagnosis of infections associated with implants and prosthetic devices, such as prosthetic joint infections (PJIs). However, practical application and additional complementary studies are still needed.
摘要：
解决与植入物相关的感染的微生物学诊断中存在的问题，以及当前关于超声流体培养（SFC）的精确性的真正力量的争论，这篇综述的目的是描述方法，分析和比较目前在该主题研究中获得的结果。此外，本研究还讨论并提出了进行超声处理的最佳参数。对解决这一研究课题的文献（2019-2023）中的最新研究进行了搜索。因此,在分析的研究中采用了不同的超声处理方案，正如预期的那样，因此，与传统培养方法(假体周围组织培养-PTC)相关的技术的敏感性和特异性的结果之间存在显著差异.SFC和PTC确定了凝固酶阴性葡萄球菌(CoNS)和金黄色葡萄球菌为主要致病因子,SFC对于鉴定难以检测的低毒力病原体很重要。与化学生物膜置换方法相比，EDTA和DTT，SFC还产生了可变结果。在这种情况下，这篇综述概述了该主题的最新情况和提高超声处理性能的理论支持，特别是在敏感性和特异性方面，通过从各个方面对最佳参数进行评分，包括样本收集，储存条件,种植方法,微生物鉴定技术（表型和分子）和集落形成单位（CFU）计数的截止点。这项研究证明了该技术标准化的必要性，并为超声处理方案提供了理论基础，该方案旨在实现与植入物和假体装置相关的感染的可靠微生物学诊断的最高水平的灵敏度和特异性。如人工关节感染（PJIs）。然而,实际应用和额外的补充研究仍然需要。
