TABLE 2 .
Sensitivity and specificity of periprosthetic tissue culture techniques using Bayesian latent class modeling and Infectious Diseases Society of America criteria for prosthetic joint infection diagnosis as gold standardsa
| Culture mediumb | No gold standard (Bayesian LCM) |
IDSA PJI criteria as gold standard |
||
|---|---|---|---|---|
| Sensitivity (95% credible interval) | Specificity (95% credible interval) | Sensitivity (95% confidence interval) | Specificity (95% confidence interval) | |
| Individual culture media | ||||
| Aerobic agar | 59.4 (45.3, 72.5) | 99.5 (98.3, 100.0) | 26.5 (18.8, 35.5) | 100.0 (98.6, 100.0) |
| Anaerobic agar | 32.2 (20.8, 45.7) | 99.5 (98.3, 100.0) | 14.5 (8.7, 22.2) | 100.0 (98.6, 100.0) |
| Thioglycolate | 74.8 (61.5, 85.8) | 99.4 (98.1, 99.9) | 33.3 (24.9, 42.6) | 100.0 (98.6, 100.0) |
| Aerobic blood culture bottle | 82.0 (69.5, 91.1) | 97.1 (94.8, 98.6) | 42.7 (33.6, 52.2) | 100.0 (98.6, 100.0) |
| Anaerobic blood culture bottle | 90.2 (79.4, 96.5) | 96.3 (93.7, 98.1) | 47.9 (38.5, 57.3) | 99.6 (97.8, 100.0) |
| Combinations of culture media | ||||
| Aerobic and anaerobic agars | 48.9 (38.3, 59.7) | 99.7 (98.7, 100.0) | 33.3 (24.9, 42.6) | 100.0 (98.6, 100.0) |
| Aerobic and anaerobic agars and thioglycolate | 62.6 (51.7, 72.5) | 98.1 (96.1, 99.3) | 44.4 (35.3, 53.9) | 98.8 (96.6, 99.8) |
| Aerobic and anaerobic BCBs | 92.1 (84.9, 97.0) | 99.7 (98.7, 100.0) | 60.7 (51.2, 69.6) | 98.8 (96.6, 99.8) |
| Aerobic and anaerobic BCBs and thioglycolate | 92.1 (84.9, 97.0) | 98.8 (97.0, 99.6) | 63.3 (53.8, 72.0) | 98.8 (96.6, 99.8) |
| Aerobic and anaerobic BCBs and aerobic agar | 94.6 (88.1, 98.6) | 99.7 (98.7, 100.0) | 62.4 (53.0, 71.2) | 98.8 (96.6, 99.8) |
| Aerobic and anaerobic BCBs and anaerobic agar | 96.8 (91.3, 99.3) | 99.8 (98.7, 100.0) | 62.4 (53.0, 71.2) | 98.0 (95.4, 99.4) |
| Aerobic and anaerobic BCBs and aerobic and anaerobic agars | 99.1 (95.7, 100.0) | 99.7 (98.7, 100.0) | 64.1 (54.7, 72.8) | 98.0 (95.4, 99.4) |
| All media combined | 99.1 (95.7, 100.0) | 97.3 (94.8, 98.7) | 67.5 (58.2, 75.9) | 96.8 (93.8, 98.6) |
Using individual culture media in periprosthetic tissue culture techniques, the prevalence of prosthetic joint infection (PJI) was 13.7% (95% credible interval of 10.4% to 17.6%) with no gold standard (Bayesian latent class modeling [LCM]), and the prevalence of PJI was 31.7% (95% confidence interval of 27.0% to 36.7%) with Infectious Diseases Society of America (IDSA) PJI criteria as the gold standard. Using combinations of culture media in periprosthetic tissue culture techniques, the prevalence of PJI was 21.7% (95% credible interval of 17.7% to 26.1%) with no gold standard (Bayesian LCM), and the prevalence of PJI was 31.7% (95% confidence interval of 27.0% to 36.7%) with IDSA PJI criteria as the gold standard.
BCBs, blood culture bottles.