An update about molecular biology techniques to detect orthopaedic implant-related infections

Esteban, Jaime; Gómez‐Barrena, Enrique

doi:10.1302/2058-5241.6.200118

Cited by 26 publications

(19 citation statements)

References 80 publications

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“…The 42% discordance could be explained by the fact that 72% of the tests were negative for microbial cultures, but only 11.5% were negative with DendrisCHIP ® OA. These data support the general trend that microbial cultures result in a higher frequency of false negatives than molecular methods [ 4 , 10 , 12 ].…”

Section: Resultssupporting

confidence: 85%

“…However, the transition to molecular syndromic-based diagnosis, i.e., allowing the detection and identification of all possible pathogen(s) responsible for an infection [ 45 , 46 , 47 ] without any preconceived ideas and in a single patient sample, is still paved with numerous technical and economic difficulties. This work was dedicated to evaluating the potential of our innovative DendrisCHIP ® technology to detect and identify bacteria commonly implicated in osteoarticular infections, which are painful and disabling diseases that are particularly difficult to diagnose [ 10 , 12 ]. We already described in a previous report that the novelty of our technology was to unlock two major limitations of the classical DNA microarrays technique, namely, to provide a higher signal to noise ratio and hence higher accessibility of nucleic acid targets to the probes by functionalization of the glass slides with dendrimers.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the microbial culture technique is relatively dependent on the expertise of the laboratory technician who decides whether or not to pick the right colonies for analysis. As Esteban et al [ 12 ] pointed out in a recent review, conventional microbiological cultures have probably reached their maximum efficiency. They advocated that the future of PJI diagnosis, as well as other areas of clinical microbiology and virology diagnostic, lies in molecular biology techniques, as they rely on genomic fingerprints that are the identity card of every biological species.…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, comparative studies have not yet determined whether these molecular methods could ever replace microbiological cultures, as, in most of these reports, the performance of these molecular methods in terms of sensitivity and specificity was not significantly superior to that of microbial cultures. However, there is a consensus that these molecular methods will be of great help in the diagnosis of PJI, which are (i) a rapid result in less than 24 h, which cannot be obtained by microbial cultures [ 12 ]; (ii) a high positive predictive value already obtained from a single specimen analyzed whereas at least three independent microbial cultures are recommended to reach a similar predictive value; and (iii) a diagnosis that can be performed on prosthetic tissues, for which microbial culture is less sensitive and specific while this type of sample is more readily available than synovial fluids or sonic fluid [ 14 , 21 ]. In addition to these technical aspects, the molecular approach to in vitro diagnostics raises the question of the need for standard references that characterize a healthy individual.…”

Section: Introductionmentioning

confidence: 99%

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The DendrisCHIP® Technology as a New, Rapid and Reliable Molecular Method for the Diagnosis of Osteoarticular Infections

et al. 2022

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Osteoarticular infections are major disabling diseases that can occur after orthopedic implant surgery in patients. The management of these infections is very complex and painful, requiring surgical intervention in combination with long-term antibiotic treatment. Therefore, early and accurate diagnosis of the causal pathogens is essential before formulating chemotherapeutic regimens. Although culture-based microbiology remains the most common diagnosis of osteoarticular infections, its regular failure to identify the causative pathogen as well as its long-term modus operandi motivates the development of rapid, accurate, and sufficiently comprehensive bacterial species-specific diagnostics that must be easy to use by routine clinical laboratories. Based on these criteria, we reported on the feasibility of our DendrisCHIP® technology using DendrisCHIP®OA as an innovative molecular diagnostic method to diagnose pathogen bacteria implicated in osteoarticular infections. This technology is based on the principle of microarrays in which the hybridization signals between oligoprobes and complementary labeled DNA fragments from isolates queries a database of hybridization signatures corresponding to a list of pre-established bacteria implicated in osteoarticular infections by a decision algorithm based on machine learning methods. In this way, this technology combines the advantages of a PCR-based method and next-generation sequencing (NGS) while reducing the limitations and constraints of the two latter technologies. On the one hand, DendrisCHIP®OA is more comprehensive than multiplex PCR tests as it is able to detect many more germs on a single sample. On the other hand, this method is not affected by the large number of nonclinically relevant bacteria or false positives that characterize NGS, as our DendrisCHIP®OA has been designed to date to target only a subset of 20 bacteria potentially responsible for osteoarticular infections. DendrisCHIP®OA has been compared with microbial culture on more than 300 isolates and a 40% discrepancy between the two methods was found, which could be due in part but not solely to the absence or poor identification of germs detected by microbial culture. We also demonstrated the reliability of our technology in correctly identifying bacteria in isolates by showing a convergence (i.e., same bacteria identified) with NGS superior to 55% while this convergence was only 32% between NGS and microbial culture data. Finally, we showed that our technology can provide a diagnostic result in less than one day (technically, 5 h), which is comparatively faster and less labor intensive than microbial cultures and NGS.

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Section: Resultssupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The DendrisCHIP® Technology as a New, Rapid and Reliable Molecular Method for the Diagnosis of Osteoarticular Infections

et al. 2022

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“… 14 . In previous studies, sensibility of this technique ranges between 48% and 72% (median 67.5%), but specificity appears to be high in all of them (range 92.1%–100%, median 96.3%) 36 . These values have been taken into account for a proper interpretation of the obtained results in the clinical scenario.…”

Section: Discussionmentioning

confidence: 68%

Usefulness of a Multiplex PCR Assay for the Diagnosis of Prosthetic Joint Infections in the Routine Setting

Auñón

Coifman

Blanco

et al. 2022

Orthopaedic Surgery

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Objective: To evaluate the usefulness of a multiplex polymerase chain reaction (PCR) assay as a complementary tool in the diagnosis of prosthetic joint infections in the routine setting of a clinical microbiology laboratory, with a special focus on patients at high risk of culture-negative infections and high suspicion of infection. Methods:The results obtained in the routine care setting with the use of the commercial multiplex PCR (Unyvero i60©, Curetis AG, Holzgerlingen, Germany) were retrospectively reviewed. The test was performed in samples of patients with suspected prosthetic joint infection, which were also processed for conventional diagnostic methods, including sonication of the implant when possible. Patients selected for the test were those with negative cultures after a 24-h incubation period.Results: Ninety-nine PCRs were performed, 57 of which were diagnostic of infection according to 2018 MSIS criteria.Nine patients received antibiotics within the 15 days prior to the diagnostic procedure. Tested samples included synovial fluid (33), sonication fluid (56) and tissue biopsies (10). The PCR test detected microorganisms in 26 samples: including two cases of polymicrobial infection. Eleven patients were diagnosed by using PCR only. The most frequently detected microorganism in PCR was Coagulase-Negative Staphylococcus in 11 samples, followed by Staphylococcus aureus in five. One sample was positive for the bacteria universal primer, included in the 2.0 version of the kit. Only one discrepancy was detected between a negative PCR and a positive culture. One sample was also positive for a resistance marker (detection of mecA gene in a case of methicillin-resistant S. aureus infection). Conclusion:The incorporation of the Unyvero ITI multiple PCR technique in patients selected by clinical experts is a useful tool for the diagnosis of bone and joint infections in a routine care setting. A close clinical-microbiological collaboration improves the usefulness of this kit for the management of patients with these infections.

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Microbiology of Bone and Joint Infections

Chebbi,

Frigui,

Achour

2024

Histopathology of Bone and Joint Infections

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An update about molecular biology techniques to detect orthopaedic implant-related infections

Cited by 26 publications

References 80 publications

The DendrisCHIP® Technology as a New, Rapid and Reliable Molecular Method for the Diagnosis of Osteoarticular Infections

The DendrisCHIP® Technology as a New, Rapid and Reliable Molecular Method for the Diagnosis of Osteoarticular Infections

Usefulness of a Multiplex PCR Assay for the Diagnosis of Prosthetic Joint Infections in the Routine Setting

Microbiology of Bone and Joint Infections

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