‘All in a box’ a concept for optimizing microbiological diagnostic sampling in prosthetic joint infections

BMC Research Notes

Table 1 Boxes’ design and transport media

	Specimen type	Bacteriological culture	16S rDNA sequencing	FISH
Joint puncture	Synovial fluid	15 mL tube (empty)*	Tube B	Tube C
Joint puncture	Synovial fluid	Blood culture vial	Tube B	Tube C
Revision surgery	Synovial fluid	15 mL tube (empty)	Tube B	Tube C
	Soft tissue	Tube A	Tube D	Tube C
	Soft tissue	Vials with Stuart transport medium (x5)*	Tube D	Tube C
	Bone biopsies	Tube A	Tube D	Tube C
	Swabs from prosthesis***	Tube A	Tube D	Tube C
	Swabs from prosthesis***	(ESwab)	Tube D	Tube C
	Prosthesis (components or in toto)	Empty container**	Tube B**	Tube C**

Tube A: Modified Amies medium (Copan). Tube B: 2 mL tube with 60% glycerol in DEPC water, targeting a final concentration ≥10% glycerol including sample; estimated final concentration ~15-20%. Tube C: CyMol® (Copan). Tube D: Modified Amies medium with 20% glycerol (Copan). The transport media were 1] modified Amies medium for direct culture, 2] CyMol® for the preservation of nucleic acids for FISH, and 3] modified Amies medium with 20% glycerol (estimated final glycerol content ~10% incl. sample) for storage of whole bacterial cells at -80°C for subsequent molecular analyses (Copan). Stuart medium (SSI Diagnostica, Copenhagen Denmark) was used for biopsies of periprosthetic soft tissue obtained according to Kamme and Lindberg[7] and handled accordingly since the 1980’s.
*Samples taken routinely during surgical revision.
**The processing of prosthetic components took place in the laboratory (summarized in[2]). ***Swabs used to prosthetic scraping in situ for culture and 16S rDNA gene sequencing were CLASSIQSwab and for FISH (CyMol®) a FLOQSwab (Copan).

ISSN: 1756-0500