{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:16:55Z","timestamp":1793409415909,"version":"4.5.0"},"reference-count":96,"publisher":"Bioscientifica","issue":"6","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":1718,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Infection is a dire complication afflicting every field of orthopaedics and traumatology. If specific clinical, laboratory and imaging parameters are present, infection is often assumed even in the absence of microbiological confirmation. However, apart from confirming infection, knowing the exact infecting pathogen(s) and their antimicrobial susceptibility patterns is paramount to help guide treatment. Every effort should therefore be undertaken with that goal in mind. Not all microbiological findings carry the same relevance, and knowing exactly how and where a sample was collected is key. Several different sampling techniques are available, and one must be aware of both advantages and limitations. Microbiological sampling alternatives in some of the most common clinical scenarios such as native and prosthetic joint infections, osteomyelitis and fracture-related infections, spinal and diabetic foot infections will be discussed. Orthopaedic surgeons should also be aware of basic laboratory sample processing techniques as they have a direct impact on the way specimens should be dealt with and transported to the laboratory. Only by knowing these basic principles will surgeons be able to participate in the multidisciplinary discussion and decision making around how to interpret microbiological findings in each specific patient.<\/jats:p>\n                  <jats:p>Cite this article: EFORT Open Rev 2021;6:390-398. DOI: 10.1302\/2058-5241.6.210011<\/jats:p>","DOI":"10.1302\/2058-5241.6.210011","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T04:44:20Z","timestamp":1624855460000},"page":"390-398","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":35,"title":["Optimal microbiological sampling for the diagnosis of osteoarticular infection"],"prefix":"10.1530","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4293-7347","authenticated-orcid":false,"given":"Ricardo","family":"Sousa","sequence":"first","affiliation":[{"name":"1Department of Orthopaedics, Centro Hospitalar Universit\u00e1rio do Porto, Porto, Portugal"},{"name":"2Porto Bone and Joint Infection Group (GRIP), Centro Hospitalar Universit\u00e1rio do Porto and Grupo TrofaSaude, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3741-849X","authenticated-orcid":false,"given":"Andr\u00e9","family":"Carvalho","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedics, Centro Hospitalar Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5888-7896","authenticated-orcid":false,"given":"Ana Cl\u00e1udia","family":"Santos","sequence":"additional","affiliation":[{"name":"2Porto Bone and Joint Infection Group (GRIP), Centro Hospitalar Universit\u00e1rio do Porto and Grupo TrofaSaude, Portugal"},{"name":"3Department of Microbiology, Centro Hospitalar Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6999-6641","authenticated-orcid":false,"given":"Miguel 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2021)."},{"key":"2026070711332126700_bibr78-2058-5241.6.210011","doi-asserted-by":"crossref","first-page":"3S","DOI":"10.1016\/j.jvs.2015.10.003","article-title":"The management of diabetic foot: a clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine","volume":"63","author":"Hingorani","year":"2016","journal-title":"J Vasc Surg"},{"key":"2026070711332126700_bibr79-2058-5241.6.210011","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1093\/cid\/cis346","article-title":"2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections","volume":"54","author":"Lipsky","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2026070711332126700_bibr80-2058-5241.6.210011","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1177\/1534734620902609","article-title":"Feasibility of percutaneous bone 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