MicroDTTect and joint infection

PJI is often difficult to diagnose as bacteria may be difficult to cultivate. The sonication of the septic explant or the use of dithiothreitol (DTT) to break up biofilms have been proposed to improve the diagnosis security by microbiological cultures. The aim of this study was to compare the diagnosis results of the commercial microDTTect device cultures with the routine PJI diagnostic and NGS from DTT treated samples. A total of 97 patients of hip and knee revision surgeries were included in this study (38 aseptic, 28 septic and 31 spacer revision). Inflammation markers like C - reactive protein levels and Leucocyte counts were analysed. We compared the microbiological diagnostic using tissue biopsies with the results of DTT-solution bacteria cultures as well as next-generation sequencing (NGS) using bacterial DNA isolated from DTT treated samples. Our data indicate that the standard microbiological diagnostic results are reliable in comparison to the microDTTect and NGS data. The use of the microDTTect device did not improve the results but gave comparable results. NGS was more efficient in detecting polybacterial infections.