[Improving the diagnosis of septic arthritis by use of a pediatric blood culture system]. / Optimierung der mikrobiologischen Diagnostik von Gelenkpunktaten mittels eines pädiatrischen Blutkultursystems.

ABSTRACT

BACKGROUND: Prognosis and outcome of bacterial joint infections are dependent on the fast and reliable identification of pathogens in the synovial fluid. Previous studies have suggested the possible advantage of using a blood culture system in contrast to conventional culture methods. PATIENTS AND METHODS: A total of 101 synovial specimens from patients presenting with symptoms suggesting septic arthritis were taken by aspiration with a sterile syringe. We compared the diagnostic results of automated analysis in a blood culture system against conventional culture on solid agar plates. RESULTS: Some 67 specimens (66.3%) were found to be negative in both preparations, while samples from 21 patients (20.8%) yielded the same microorganisms. In 13 cases (12.9%), the isolation of a pathogen was possible only with the blood culture method, whereas the conventional method never yielded a positive result when the blood culture was negative. Thus, the diagnostic yield was significantly improved by use of the blood culture system (P <0.001). CONCLUSION: The use of a commonly available blood culture system offers a fast, reliable and cost-effective approach for the diagnosis of septic arthritis and should therefore be considered as an useful alternative to conventional culture methods.