Comparison Between Culture-positive And Culture-negative Periprosthetic Infections:The Clinical Characteristic And Prognosis

Background:Periprosthetic joint infection is one of complication after arthroplasty,which can lead to higher morality and expense.Lack of confirmation of an infecting organism poses a challenge to treat periprosthetic joint infection.This study try to compare the clinical characteristic and prognosis between the culture-negative and culture-positive PJI.Methods:This study retrospectively review the PJI patients treated at our institution.Information such as microbiological data,cnegative linical outcomes,and other details of patients5 clinical courses were recorded.The infection-free survival rate and clinical manifestation was compared in the culture-patients with that of culture-positive cases of PJI.Then a literature review and meta-analysis was performed to compare the re-infection rate between the culture-negative and culture-positive PJI patients.Results:Overall re-infection rate was 10.5%in culture-negative cases and 20.8%in culture-positive cases at minimum 1-year follow-up.These infection control rates compared between two groups showed no significant difference.CultUre-negative PJIs seemed associated with referral from elsewhere(p=0.041).And the CRP level was lower in the Culture-negative PJIs(p<0.001).Conclusion:The culture-negative PJI patients achieves similar rates of infection-free survival as with patients having culture-positive PJI.