National periprosthetic joint infection sampling and culture guide

Joint replacements greatly improve quality of life. While subsequent prosthetic joint infection (PJI) is uncommon it can have a significant impact for the patient.

The accurate diagnosis of PJI is essential to ensure the best antibiotic treatment and surgical management of the patient. Because a significant proportion of PJIs are caused by common skin organisms, multiple samples are needed to allow reliable interpretation of culture results.

This sampling and culture guide provides advice on:

• the type of samples to collect
• the number of samples to collect
• sample collection
• timing of surgical antibiotic prophylaxis with respect to tissue sampling
• culture approaches
• relevance of Propionibacterium acnes for shoulder PJI.

The guide should improve the consistency of approach to diagnosing prosthetic joint infections.