TABLE 2.

Additional pathogens identified in sonicate fluid by the BCID panel and not detected by sonicate fluid culture

Additional pathogen detected by BCID	Conventional culture results for pathogen detected by BCID	Pathogen(s) coisolated by culture	Recent antimicrobial therapy	Corroborative molecular testing result(s)
mecA-negative SCN	Sonicate cultures with <20 CFU/10 ml SCN	None	Fusidic acid until surgery	PCR/ESI-MS, S. caprae/epidermidis; 16S rRNA gene PCR, Staphylococcus sp.; 10-assay PCR panel, SCN
mecA-negative S. aureus	Nonea	Methicillin-resistant SCN	Oxacillin until surgery	16S rRNA gene PCR + 10-assay PCR panel, S. aureus
Streptococcus agalactiae (GBS)	Sonicate cultures with <20 CFU/10 ml GBSb	None	Penicillin G/ceftriaxone until surgery	16S rRNA gene PCR + 10-assay PCR panel, GBS
Klebsiella pneumoniae	Sonicate cultures with <20 CFU/10 ml K. pneumoniaec	None	Trimethoprim-sulfamethoxazole–rifampin until 7 days before surgery	10-assay PCR panel, Enterobacteriaceae
Enterobacter cloacae	None	MRSA,e Finegoldia magna, Corynebacterium species	Trimethoprim-sulfamethoxazole until 7 days before surgery	10-assay PCR panel, Enterobacteriaceae
Candida albicans	Noned	Methicillin-resistant S. epidermidis	Trimethoprim-sulfamethoxazole–levofloxacin until 3 days before surgery	None

^aCultures from external institution with methicillin-sensitive S. aureus previously.

^bPreoperative aspirate with GBS (group B Streptococcus species).

^cOne of five tissue cultures with K. pneumoniae.

^dNone detected in corresponding sonicate cultures; however, C. albicans was detected in operative cultures obtained 1 month later when the cement spacer was replaced.

^eMRSA, methicillin-resistant S. aureus.