Established diagnostic tests exist for rapid organism identification
of a limited number of organisms. However, until now, there
has not been a rapid way to identify most bacteria and fungi isolated
from the site of a prosthetic joint, and conventional (nonrapid) microbiological
techniques have had a limited capacity to identify most isolated
organisms to the species level (Harris et al., 2010). Moreover,
traditional methods
for identification of most isolated organisms to the species
level are associated with significant cost. For these reasons, organisms
such as the CoNS and Corynebacterium species have not historically
been identified to the species level on a routine basis. Doing so would
have required sophisticated and expensive biochemical and/or molecular
testing and would not have been rapid. Although limited identification
of these organisms has been accepted in clinical practice, it is possible that
clinical differentiation between contaminated specimens and infection
might be aided by species-level identification of these organisms.
With the advent of matrix-assisted laser desorption ionization time
of flight mass spectrometry (MALDI-TOF MS), rapid and accurate identification
of bacteria to the species level is possible in routine clinical