Tanı
- Klinik
- Serolojik
- Aspirasyon
- Eklem sıvısının değerlendirilmesi
| Organism | No. |
| Coagulase-negative staphylococci (Staph. Epidermidis) | 648 ➡️ %28 Gram (+) |
| Staphylococcus aureus | 636 ➡️ %28 Gram (+) |
| Streptococci, not A or D | 168 |
| Anaerobic streptococci | 135 |
| Pseudomonas | 131 |
| Escherichia coli | 129 |
| Enterococcus | 104 |
| Corynebacterium (anaerobic) | 74 |
| Proteus | 73 |
| Propionibacterium acnes | 40 |
| Klebsiella | 31 |
| Enterobacter cloacae | 24 |
| Diphtheroid | 22 |
| Group A streptococcus | 17 |
| Bacteroides fragilis | 12 |
| Bacillus | 11 |
| Candida | 8 |
| Serratia | 8 |
| Salmonella | 7 |
| Tubercle bacteria | 6 |
| Acinetobacter | 6 |
| Aerobacter | 6 |
| Other | 40 |
Methicilin resistance Glycocalyx(+) ➡️ Higher VIRULENCE!!! (Staphylococcus and Pseudomonas)
Gram (-) hematogenous infections (urinary)
Mixed infections – draining sinus (superinfection)
From Salvati EA, Della Valle AG, Masri BA, et al: The infected total hip arthroplasty, Instr Course Lect 52:223, 2003.
| Intraoperative | Sensitivity | Specificity |
| Surgeon’s impression(macroscopic) | 70 | 87 |
| Gram stain ☹ | 19 | 98 |
| Frozen section ☺ | 80 | 94 |
| Culture of tissue ☺ ☺ ☺ | 94 | 97 |
| Swab culture ☺ | 76 | 99 |
Eklem aspirasyonu
- 2 hafta önce antibiyotik kesilmeli
- Serum konsantrasyonu
- Hemen ekilmeli, gram boyama
- En az 2 pozitif kültür
- inovyal hücre sayımı
*Sinovyal CRP 9.5 mg/lt
**Lökosit esteraz (%81 sensitif, %100 spesifik)
***α- Defensin
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