Marculescu et al listed criteria for the diagnosis of a prosthetic joint infection. The authors are from the Medical University of South Carolina and the Mayo Clinic.
Clinical findings - one or more of the following:
(1) presence of acute inflammation on histopathologic examination of a biopsy
(2) presence of a sinus tract communicating with the prosthesis
(3) presence of purulence about the prosthesis seen at surgery
The infection may be culture positive or negative. It is considered culture positive if the same microorganism is isolated from >= 2 suitable cultures (aspirate, operative sample, etc.).
Confidence in culture results are increased:
(1) If the chances of contamination are low. For example, cultures taken from the opening of a sinus tract may be contaminated with skin flora.
(2) If the isolated organism is a known pathogen like Staphylococcus aureus.
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