Vitek 2 cards

During surgical procedures, at least 3 samples were taken from different areas suspected of being infected using a separate sterile instrument for each sample and were sent to the laboratory within 2 hours. The samples were processed in a class 2 biosafety cabinet. Firstly, solid samples were vortexed without sonication in sterile water for one minute (Ultra Turrax®, IKA, Staufen, Germany). Each sample was then plated for five days at 35°C onto Columbia agar with blood 5% and chocolate agar with polyvitex, and for 14 days in aerobic and anaerobic bottles (1 mL in each bottle) in the BacT/Alert® Virtuo blood culture bottle system (BioMérieux, Marcy l'Etoile, France). Strains were identified using MALDI-TOF spectrometry mass (Bruker Daltonics, Wissembourg, France) with a minimal score requirement of 2. The antibiotic susceptibility profile of all pathogens identified from intraoperative samples was assessed either by the Vitek 2 cards (BioMérieux, Marcy l'Etoile, France) or by agar diffusion technique using the procedure and interpretation criteria proposed by the Comité de l'Antibiogramme de la Société Française de Microbiologie (CA-SFM EUCAST 2018) (http://www.sfm-microbiologie.org).

Biological parameters including blood C-reactive protein and renal and hepatic functions were collected during the episode of infection and during the treatment period. Per-operative specimens were recorded for each patient: number of positive specimens and susceptibility profile to antibiotics. Streptococci yielded from intraoperative sample cultures on standard medium and enriched broth were identified by automated techniques [API® strips (Biomérieux, Marcy l Marcy, France) and VITEK2® cards (Biomérieux, Marcy l Marcy, France). The antimicrobial susceptibility tests were also performed on the VITEK2® automate (Biomérieux, Marcy l, France).
The diffusion agar technique was used in each case, and the procedure and interpretation of the susceptibility tests were performed in accordance with the Comité de l’Antibiogramme de la Société Française de Microbiologie; annual guides from 2001 to 2011) recommendations (http://www.sfm-microbiologie.org).