Sonication protocols and their contributions to the microbiological diagnosis of implant-associated infections: a review of the current scenario.

Addressing the existing problem in the microbiological diagnosis of infections associated with implants and the current debate about the real power of precision of sonicated fluid culture (SFC), the objective of this review is to describe the methodology and analyze and compare the results obtained in current studies on the subject. Furthermore, the present study also discusses and suggests the best parameters for performing sonication. A search was carried out for recent studies in the literature (2019-2023) that addressed this research topic. As a result, different sonication protocols were adopted in the studies analyzed, as expected, and consequently, there was significant variability between the results obtained regarding the sensitivity and specificity of the technique in relation to the traditional culture method (periprosthetic tissue culture - PTC). Coagulase-negative Staphylococcus (CoNS) and Staphylococcus aureus were identified as the main etiological agents by SFC and PTC, with SFC being important for the identification of pathogens of low virulence that are difficult to detect. Compared to chemical biofilm displacement methods, EDTA and DTT, SFC also produced variable results. In this context, this review provided an overview of the most current scenarios on the topic and theoretical support to improve sonication performance, especially with regard to sensitivity and specificity, by scoring the best parameters from various aspects, including sample collection, storage conditions, cultivation methods, microorganism identification techniques (both phenotypic and molecular) and the cutoff point for colony forming unit (CFU) counts. This study demonstrated the need for standardization of the technique and provided a theoretical basis for a sonication protocol that aims to achieve the highest levels of sensitivity and specificity for the reliable microbiological diagnosis of infections associated with implants and prosthetic devices, such as prosthetic joint infections (PJIs). However, practical application and additional complementary studies are still needed.

Análise comparativa da técnica de baciloscopia no diagnósticoda tuberculose pulmonar frente ao GeneXpert em amostras depacientes da cidade de Recife, Pernambuco / Comparative analysis of the bacilloscopy technique in the diagnosis of pulmonary tuberculosis against GeneXpert in samples of patients in the city of Recife, Pernambuco

Objetivo: Considerando que atualmente ainda existem algumas limitações quanto à escolha do teste ideal para diagnóstico da TB, ligadas principalmente aos custos e realização adequada das técnicas, o presente estudo teve por objetivo verificar a eficácia do teste de baciloscopia no diagnóstico da tuberculose pulmonar, a partir da comparação dos resultados obtidos através dos testes de baciloscopia e GeneXpert de pacientes da cidade de Recife-PE. Métodos: Foram analisadas neste estudo amostras de escarro com os resultados já positivos para TB através da cultura microbiológica. As espécimes foram submetidas ainda aos testes de baciloscopia e GeneXpert para uma análise comparativa dos resultados. Resultados: Foi analisado um total de 100 amostras, com positividade para todos os testes realizados no estudo (cultura microbiológica, GeneXpert e baciloscopia). Conclusão: O diagnóstico através do GeneXpert representa um ganho expressivo quando levado em conta sua sensibilidade, rapidez e confiabilidade dos resultados, em contrapartida, os custos para realização deste teste ainda são elevados. Este fato reforça a importância das metodologias convencionais de baciloscopia e cultura, quando utilizadas dentro dos parâmetros de controle de qualidade adequados.

Objective: Considering that currently there are still some limitations regarding the choice of the ideal test for diagnosis of TB, related mainly to costs and adequate performance of the techniques, the present study aimed to verify the efficacy of the bacilloscopy test in the diagnosis of pulmonary tuberculosis, based on the comparison of the results obtained through the bacilloscopy and GeneXpert tests of patients from the city of Recife-PE. Methods: Sputum samples with already positive results for TB were analyzed in this study through the microbiological culture. The specimens were also submitted to bacilloscopy and GeneXpert tests for a comparative analysis of the results. Results: A total of 100 samples were analyzed, with positivity for all tests performed in the study (microbiological culture, GeneXpert and smear microscopy). Conclusion: The diagnosis through GeneXpert represents an expressive gain when taking into account its sensitivity, speed and reliability of results, in contrast, the costs to perform this test are still high. This fact reinforces the importance of conventional bacilloscopy and culture methodologies when used within the appropriate quality control parameters