AUTHOR=Kolenda Camille , Josse Jérôme , Batailler Cécile , Faure Allison , Monteix Alice , Lustig Sébastien , Ferry Tristan , Laurent Frédéric , Dupieux Céline 

TITLE=Experience With the Use of the MicroDTTect Device for the Diagnosis of Low-Grade Chronic Prosthetic Joint Infections in a Routine Setting

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.565555

DOI=10.3389/fmed.2021.565555

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> In prosthetic joint infections (PJIs), identification of the causative microorganisms is critical to successfully adapt and optimize treatment. However, microbiological diagnosis of PJIs remains a challenge notably because bacteria are embedded in biofilm adhered to the prosthetic material. Recently, dithiothreitol (DTT) treatment of prosthesis has been proposed as a new strategy to release bacteria from biofilm and to improve the yield of microbiological diagnosis. In this study, we evaluated the interest of a commercial device using DTT, the MicroDTTect system (Heraeus, Hanau, Germany), for the diagnosis of low-grade chronic PJIs, compared to the conventional culture of periprosthetic tissue (PPT) samples.</p><p><bold>Methods:</bold> Twenty patients undergoing a surgery procedure for removal of prosthetic material because of a suspicion of low-grade PJI without pre-operative microbiological documentation were included (NCT04371068). Bacteriological results using the fluid obtained after prosthesis treatment with the MicroDTTect system were compared to results obtained with conventional culture of PPT samples.</p><p><bold>Results:</bold> All the bacteria considered as responsible for PJIs recovered from culture of PPT samples were also detected using the MicroDTTect device. For one patient, an additional bacterial isolate (<italic>Staphylococcus haemolyticus</italic>) suspected to be involved in a polymicrobial PJI was identified using DTT treatment. Time to positivity of the cultures was also reduced using the MicroDTTect system, notably in case of <italic>Cutibacterium acnes</italic> infection. However, probable bacterial contaminants were found (MicroDTTect system, <italic>n</italic> = 5; PPT samples, <italic>n</italic> = 1).</p><p><bold>Conclusion:</bold> This study showed that DTT treatment of the prosthetic component using the MicroDTTect device could improve the microbiological diagnosis of low-grade PJIs.</p>