New Approaches to the Diagnosis of Prosthetic Joint Infection


Prosthetic joint infection occurs as a result of the formation of biofilms on the surface of orthopedic implants. The number of prosthetic joint infections is rising; diagnosis of this condition can be challenging. Our group has an over two decade history of performing studies to try to improve the diagnosis of prosthetic joint infection. A decade ago, we described a strategy to sample bacteria growing in biofilms on surfaces of removed joint replacements, an approach that is now a standard means of prosthetic joint infection diagnosis. In addition, this tactic is enabling us to answer a number of fundamental questions about the microbiology and pathogenesis of prosthetic joint infection through multiplex nucleic acid amplification panel, broad-range polymerase chain reaction and deep sequencing studies. Last year, we described an improved method for culturing tissue specimens from around orthopedic implants. We have defined how to interpret results of blood tests (e.g., CRP, ESR) and synovial fluid tests (e.g., cell count, neutrophil differential) for prosthetic joint infection diagnosis. This presentation will provide an overview of the diagnosis of prosthetic joint infection.

Originally presented on February 16, 2017, in Salt Lake City, Utah and recorded with permission.

Lecture Presenter

Robin Patel, MD(CM), FRCP(C), D(ABMM), FIDSA, FACP, F(AAM)

Robin Patel, MD(CM), FRCP(C), D(ABMM), FIDSA, FACP, F(AAM)

Chair, Division of Clinical Microbiology
College of Medicine, Mayo Clinic
Consultant, Divisions of Clinical Microbiology and Infectious Diseases
College of Medicine, Mayo Clinic
Professor of Microbiology and Medicine
College of Medicine, Mayo Clinic

Dr. Robin Patel graduated from Princeton University with a BA in Chemistry in 1985 and from McGill University in Montreal, Canada with an M.D.(C.M.) in 1989. She then moved to Rochester, Minnesota, where she completed residencies in Internal Medicine and Microbiology and a fellowship in Infectious Diseases at the College of Medicine, Mayo Clinic. In 1996, upon completion of post-graduate training, she joined the staff of Mayo Clinic. She is currently Professor of Medicine, and Professor of Microbiology, Director of the Clinical Bacteriology Laboratory and the Infectious Diseases Research Laboratory, and Chair of the Division of Clinical Microbiology, Mayo Clinic.

Dr. Patel is board certified in Infectious Diseases (American Board of Internal Medicine), Medical Microbiology/Public Health Microbiology (American Board of Medical Microbiology), Clinical Pathology/Medical Microbiology (American Board of Pathology), and Internal Medicine, Medical Microbiology and Infectious Diseases (Collège des Médecins du Québec and Royal College of Physicians and Surgeons of Canada).

Dr. Patel’s research focuses on clinical bacteriology diagnostic testing, antimicrobial resistance, and microbial biofilms. She has published over 250 peer reviewed manuscripts and has delivered numerous national and international presentations. She is a Fellow of American Academy of Microbiology, a past member of the IDWeek Program Planning Committee, the chair of the United States Medical Licensing Examination Microbiology and Immunology Test Material Development Committee and the co-chair of the ASM Microbe 2016-2018 Program Planning Committee. She is an associate editor for the Journal of Clinical Microbiology and Clinical Infectious Diseases and the course director for the Mayo Medical School Microbiology course.


After this presentation, participants will be able to:

  • Learn the epidemiology, pathogenesis, and microbiology of prosthetic joint infection.
  • Interpret synovial fluid cell count and neutrophil differential values in patients with a prosthetic joint.
  • Determine appropriate specimen types for culture for diagnosing prosthetic joint infection.

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories