Important Note

Note:  The Orthopedic Extended Culture with Gram stain order is intended for suspected prosthetic joint infection. This order automatically cultures for aerobic and anaerobic bacteria with an extended incubation time of 14 days for the anaerobic culture portion for coverage of anaerobic organisms such as Cutibacterium sp.. Prosthetic joint infections are frequently caused by bacteria that are considered normal cutaneous microbiota; the organisms vary dependent upon the joint infected and the time between implantation and infection. Conversely, native joint infections are commonly caused by the hematogenous spread from bacteremia or by direct inoculation from bites, injection injuries, cellulitis, abscesses, or local trauma. The Orthopedic Extended Culture is not appropriate for native joint infection cases; order Bacterial Culture, Other with Gram stain (MICR0032) for suspected native joint infection.  Culture of synovial fluid and explanted tissue or periprosthetic tissue are the preferred sample types for this order.