Microbiology and Culture Identification of Infections

Abstract

Microbiologic analysis of synovial fluid remains an important component when joint infection is suspected. Organism identification and susceptibility testing are essential for targeted antimicrobial therapy and optimization of patient management decisions. Following needle aspiration using sterile technique, specimen should be sent to the laboratory. When possible, best practice is to place specimen directly into blood culture vials at bedside and submit additional fluid for Gram stain and bacterial culture. Assessment for fungi, mycobacteria, and other rare pathogens are recommended in the setting of negative routine cultures, likely exposure, immunosuppression, or a chronic unexplained systemic disease. This chapter outlines best practice methods and provides details for performing microbiologic culture, including special considerations for prosthetic joint infection.