ArticleInternational orthopaedics2023
Dithiotreitol pre-treatment of synovial fluid samples improves microbiological counts in peri-prosthetic joint infection.
Article in International orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Optimized use and performance of culture for periprosthetic joint infection diagnosis: a comprehensive literature review.Clinical microbiology reviews · 2025Pooled it
- Reducing culture underestimation in urine: flow cytometry-guided validation of low-dose DTT pre-treatment for biofilm dispersal.Microbiology spectrum · 2026Article
- Engineered Mycoplasma pneumoniae targeting dual-species bacterial biofilms: a novel strategy against infections.NPJ biofilms and microbiomes · 2025Article
- Viscosupplementation and Synovial Fluid Rheology: A Hidden Risk for Bacterial Biofilm Formation in Joint Infections?Microorganisms · 2025Review
- Modern Microbiological Methods to Detect Biofilm Formation in Orthopedy and Suggestions for Antibiotic Therapy, with Particular Emphasis on Prosthetic Joint Infection (PJI).Microorganisms · 2024Review
- Role of Dithiothreitol in Detection of Orthopaedic Implant-Associated Infections.Journal of personalized medicine · 2024Article
- Bacteria Living in Biofilms in Fluids: Could Chemical Antibiofilm Pretreatment of Culture Represent a Paradigm Shift in Diagnostics?Microorganisms · 2024Review
- Biofilm Related Total Knee Arthroplasty Infection: Prevention, Diagnosis and Treatment.The archives of bone and joint surgery · 2024Article
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSynovial fluid cultures of periprosthetic joint infections (PJI) may be limited by bacteria living in the fluids as biofilm-aggregates. The antibiofilm pre-treatment of synovial fluids with dithiotreitol (DTT) could improve bacterial counts and microbiological early stage diagnosis in patients with suspected PJI.
methodsSynovial fluids collected from 57 subjects, affected by painful total hip or knee replacement, were divided into two aliquots, one pre-treated with DTT and one with normal saline. All samples were plated for microbial counts. Sensitivity of cultural examination and bacterial counts of pre-treated and control samples were then calculated and statistically compared.
resultsDithiothreitol pre-treatment led to a higher number of positive samples, compared to controls (27 vs 19), leading to a statistically significant increase in the sensitivity of the microbiological count examination from 54.3 to 77.1% and in colony-forming units count from 1884 ± 2.129 CFU/mL with saline pre-treatment to 20.442 ± 19.270 with DTT pre-treatment (P = 0.02).
conclusionsTo our knowledge, this is the first report showing the ability of a chemical antibiofilm pre-treatment to increase the sensitivity of microbiological examination in the synovial fluid of patients with peri-prosthetic joint infection. If confirmed by larger studies, this finding may have a significant impact on routine microbiological procedures applied to synovial fluids and brings further support to the key role of bacteria living in biofilm-formed aggregates in joint infections.
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