Session Type: ePosters
Session Title: ePosters
Authors(s): L. Cottom (1), P. Wright (2)
Authors Affiliations(s): (1) Glasgow Royal Infirmary, United Kingdom, (2) Queen Elizabeth Hospital, United Kingdom
Third Party Affiliation: NA
Background:
Arthroplasty remains an effective surgical intervention that improves quality of life. In Scotland over the last decade there has been almost a 50% increase in the number of cases of both knee and hip arthroplasty, with 15,091 cases on being performed in 2018 (compared to 7,562 cases in 2001). The incidence of periprosthetic infection following hip and knee arthroplasty is estimated to be 1–2%, and is dependent on a host of factors. Prosthetic joint infection (PJI) albeit rare, remains an important diagnostic and therapeutic challenge, associated with significant morbidity and mortality. An initial evaluation in 2015 assessing intra-operative sampling and the laboratory process lead to a restructuring of workflow, development and implementation of a standardised laboratory algorithm including inclusion of an automated continuous monitoring blood culture system. Following on from previous audits of compliance our aim was to evaluate the impact of the above interventions over the last 6 years on intra-operative sampling, the percentage of culture positive specimens (growth of a significant organism) and time to culture positivity.
Methods:A retrospective analysis was performed over a 4-month period extending from May to August 2015-2020. Patients were identified using our electronic clinical record system (Clinical Portal) and laboratory information management system (Telepath). Any patient who had intra-operative samples sent for microbiological investigation for a suspected or confirmed infection involving a knee or hip arthroplasty was included. Cases were only included for analysis when the PJI diagnosis had been confirmed according to either the clinical practice guidelines by the Infectious Diseases Society of America (IDSA) or on clinical judgement.
Results:Following the above interventions the mean number of intra-operative specimens sent per case increased from 4 in 2015 to 6 for both 2019 and 2020. In assessing the positivity rate & comparing this for each year post intervention a statistically significant increase in the number of culture positive specimens (significant pathogen being cultured) was demonstrated (Chi-square test: P value < 0.0001).
Conclusions:PJI remains an important complication of arthroplasty. Our integrated approach has resulted in a significant sustained improvement in the microbiological diagnosis and supports optimisation of clinical care pathways.
Keyword(s): Orthopaedic related infections, Surveillance (Antimicrobial resistance & susceptibility), Epidemiology of Prosthetic Joint infectionsSession Type: ePosters
Session Title: ePosters
Authors(s): L. Cottom (1), P. Wright (2)
Authors Affiliations(s): (1) Glasgow Royal Infirmary, United Kingdom, (2) Queen Elizabeth Hospital, United Kingdom
Third Party Affiliation: NA
Background:
Arthroplasty remains an effective surgical intervention that improves quality of life. In Scotland over the last decade there has been almost a 50% increase in the number of cases of both knee and hip arthroplasty, with 15,091 cases on being performed in 2018 (compared to 7,562 cases in 2001). The incidence of periprosthetic infection following hip and knee arthroplasty is estimated to be 1–2%, and is dependent on a host of factors. Prosthetic joint infection (PJI) albeit rare, remains an important diagnostic and therapeutic challenge, associated with significant morbidity and mortality. An initial evaluation in 2015 assessing intra-operative sampling and the laboratory process lead to a restructuring of workflow, development and implementation of a standardised laboratory algorithm including inclusion of an automated continuous monitoring blood culture system. Following on from previous audits of compliance our aim was to evaluate the impact of the above interventions over the last 6 years on intra-operative sampling, the percentage of culture positive specimens (growth of a significant organism) and time to culture positivity.
Methods:A retrospective analysis was performed over a 4-month period extending from May to August 2015-2020. Patients were identified using our electronic clinical record system (Clinical Portal) and laboratory information management system (Telepath). Any patient who had intra-operative samples sent for microbiological investigation for a suspected or confirmed infection involving a knee or hip arthroplasty was included. Cases were only included for analysis when the PJI diagnosis had been confirmed according to either the clinical practice guidelines by the Infectious Diseases Society of America (IDSA) or on clinical judgement.
Results:Following the above interventions the mean number of intra-operative specimens sent per case increased from 4 in 2015 to 6 for both 2019 and 2020. In assessing the positivity rate & comparing this for each year post intervention a statistically significant increase in the number of culture positive specimens (significant pathogen being cultured) was demonstrated (Chi-square test: P value < 0.0001).
Conclusions:PJI remains an important complication of arthroplasty. Our integrated approach has resulted in a significant sustained improvement in the microbiological diagnosis and supports optimisation of clinical care pathways.
Keyword(s): Orthopaedic related infections, Surveillance (Antimicrobial resistance & susceptibility), Epidemiology of Prosthetic Joint infections
Department of Clinical Microbiology, Glasgow Royal Infirmary, Glasgow, UK
Session Type: ePosters
Session Title: ePosters
Authors(s): L. Cottom (1), P. Wright (2)
Authors Affiliations(s): (1) Glasgow Royal Infirmary, United Kingdom, (2) Queen Elizabeth Hospital, United Kingdom
Third Party Affiliation: NA
Background:
Arthroplasty remains an effective surgical intervention that improves quality of life. In Scotland over the last decade there has been almost a 50% increase in the number of cases of both knee and hip arthroplasty, with 15,091 cases on being performed in 2018 (compared to 7,562 cases in 2001). The incidence of periprosthetic infection following hip and knee arthroplasty is estimated to be 1–2%, and is dependent on a host of factors. Prosthetic joint infection (PJI) albeit rare, remains an important diagnostic and therapeutic challenge, associated with significant morbidity and mortality. An initial evaluation in 2015 assessing intra-operative sampling and the laboratory process lead to a restructuring of workflow, development and implementation of a standardised laboratory algorithm including inclusion of an automated continuous monitoring blood culture system. Following on from previous audits of compliance our aim was to evaluate the impact of the above interventions over the last 6 years on intra-operative sampling, the percentage of culture positive specimens (growth of a significant organism) and time to culture positivity.
Methods:A retrospective analysis was performed over a 4-month period extending from May to August 2015-2020. Patients were identified using our electronic clinical record system (Clinical Portal) and laboratory information management system (Telepath). Any patient who had intra-operative samples sent for microbiological investigation for a suspected or confirmed infection involving a knee or hip arthroplasty was included. Cases were only included for analysis when the PJI diagnosis had been confirmed according to either the clinical practice guidelines by the Infectious Diseases Society of America (IDSA) or on clinical judgement.
Results:Following the above interventions the mean number of intra-operative specimens sent per case increased from 4 in 2015 to 6 for both 2019 and 2020. In assessing the positivity rate & comparing this for each year post intervention a statistically significant increase in the number of culture positive specimens (significant pathogen being cultured) was demonstrated (Chi-square test: P value < 0.0001).
Conclusions:PJI remains an important complication of arthroplasty. Our integrated approach has resulted in a significant sustained improvement in the microbiological diagnosis and supports optimisation of clinical care pathways.
Keyword(s): Orthopaedic related infections, Surveillance (Antimicrobial resistance & susceptibility), Epidemiology of Prosthetic Joint infectionsSession Type: ePosters
Session Title: ePosters
Authors(s): L. Cottom (1), P. Wright (2)
Authors Affiliations(s): (1) Glasgow Royal Infirmary, United Kingdom, (2) Queen Elizabeth Hospital, United Kingdom
Third Party Affiliation: NA
Background:
Arthroplasty remains an effective surgical intervention that improves quality of life. In Scotland over the last decade there has been almost a 50% increase in the number of cases of both knee and hip arthroplasty, with 15,091 cases on being performed in 2018 (compared to 7,562 cases in 2001). The incidence of periprosthetic infection following hip and knee arthroplasty is estimated to be 1–2%, and is dependent on a host of factors. Prosthetic joint infection (PJI) albeit rare, remains an important diagnostic and therapeutic challenge, associated with significant morbidity and mortality. An initial evaluation in 2015 assessing intra-operative sampling and the laboratory process lead to a restructuring of workflow, development and implementation of a standardised laboratory algorithm including inclusion of an automated continuous monitoring blood culture system. Following on from previous audits of compliance our aim was to evaluate the impact of the above interventions over the last 6 years on intra-operative sampling, the percentage of culture positive specimens (growth of a significant organism) and time to culture positivity.
Methods:A retrospective analysis was performed over a 4-month period extending from May to August 2015-2020. Patients were identified using our electronic clinical record system (Clinical Portal) and laboratory information management system (Telepath). Any patient who had intra-operative samples sent for microbiological investigation for a suspected or confirmed infection involving a knee or hip arthroplasty was included. Cases were only included for analysis when the PJI diagnosis had been confirmed according to either the clinical practice guidelines by the Infectious Diseases Society of America (IDSA) or on clinical judgement.
Results:Following the above interventions the mean number of intra-operative specimens sent per case increased from 4 in 2015 to 6 for both 2019 and 2020. In assessing the positivity rate & comparing this for each year post intervention a statistically significant increase in the number of culture positive specimens (significant pathogen being cultured) was demonstrated (Chi-square test: P value < 0.0001).
Conclusions:PJI remains an important complication of arthroplasty. Our integrated approach has resulted in a significant sustained improvement in the microbiological diagnosis and supports optimisation of clinical care pathways.
Keyword(s): Orthopaedic related infections, Surveillance (Antimicrobial resistance & susceptibility), Epidemiology of Prosthetic Joint infections