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 mediumbNo 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 agar59.4 (45.3, 72.5)99.5 (98.3, 100.0)26.5 (18.8, 35.5)100.0 (98.6, 100.0)
    Anaerobic agar32.2 (20.8, 45.7)99.5 (98.3, 100.0)14.5 (8.7, 22.2)100.0 (98.6, 100.0)
    Thioglycolate74.8 (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 bottle82.0 (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 bottle90.2 (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 agars48.9 (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 thioglycolate62.6 (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 BCBs92.1 (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 thioglycolate92.1 (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 agar94.6 (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 agar96.8 (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 agars99.1 (95.7, 100.0)99.7 (98.7, 100.0)64.1 (54.7, 72.8)98.0 (95.4, 99.4)
    All media combined99.1 (95.7, 100.0)97.3 (94.8, 98.7)67.5 (58.2, 75.9)96.8 (93.8, 98.6)
  • a 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.

  • b BCBs, blood culture bottles.