Applications of molecular pathology in the diagnosis of joint infections

Kriegsmann, Jörg; Hopf, T.; Jacobs, Daniel; Arens, Norbert; Krenn, Veit; Schmitt-Wiedhoff, R.; Kriegsmann, Mark; Heisel, Christian; Biehl, Christoph; Thabe, H.; Schmitz, Roland; Lehmann, Marc; Otto, Mike

doi:10.1007/s00132-008-1394-2

Cited by 30 publications

(8 citation statements)

References 37 publications

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“…Intraoperativ sollten mehrere Gewebeproben entnommen werden. Bei unklaren Befunden empfehlen wir zusätzlich eine histologische Untersuchung, um auf der einen Seite bei Low-grade-Infektionen falsch-negative mikrobiologische Nachweise von wenig virulenten Keimen aufzudecken, auf der anderen Seite aber gerade beim Nachweis von nicht oder wenig pathogenen Keimen oder fehlendem Keimwachstum einen solche Infekt nicht zu übersehen [4][5][6]. Bei immungeschwächten Patienten können durchaus atypische oder nicht virulente Keime relevante Infektionen verursachen [1,7].…”

Section: Diskussionunclassified

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et al. 2016

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ZusammenfassungEin 57-jähriger Patient wurde aus der internistischen Abteilung einer auswärtigen Klinik übernommen, mit zahlreichen Gichttophi und einer Überwärmung des rechten Knies und des rechten Ellenbogens. Seit 20 Tagen bestand eine probatorische parenterale Antibiotikatherapie. Durch eine sofortige Punktion des rechten Kniegelenks konnte die Diagnose einer bakteriellen Arthritis gestellt werden. Es erfolgte umgehend eine Operation mit Spülung und ausführlichem Debridement unter der Weiterführung der Antibiotikatherapie. Bei Patienten mit Gicht und Verdacht auf eine zusätzliche Infektion muss immer eine vollständige und konsequente Fokussuche und ggf. eine operative Focussanierung durchgeführt werden.

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Section: Diskussionunclassified

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et al. 2016

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“…Obviously, new fields of application are demanded not only for reason of business development but also due to the fact that PCR application is impacted by the above-mentioned side effects. The VYOO ® assay, originally intended for sepsis pathogens in whole blood, has also been applied in pathogen detection in ascites in cases of spontaneous bacterial peritonitis (SBP, [135]) and synovial fluids [136], in which pathogen cell numbers are probably not as low as in blood of septic patients.…”

Section: Microbial Trace Detection In Bsi Ascites and Synovial Fluidsmentioning

confidence: 99%

Nucleic Acid Amplification Techniques

Lehmann¹,

Schmitz

2015

Modern Techniques for Pathogen Detection

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Nucleic acid amplification techniques (NATs), more commonly but imprecisely called polymerase chain reaction (PCR), have evolved, among others, as central tools for pathogen identification and strain typing. The huge field of applications of the technique in all its modifications already marks the centerpiece of diagnostic approaches and has not only opened the door to a completely new understanding of elementary and sophisticated metabolic processes but also is the basis of the most important trends in life science industries. In a sense, it acts as the lens of a molecular microscope which visualizes the code from the genomic book, while its meanings have to be deciphered by a further armory of laboratory avenues.In 1983, PCR was invented by Kary Mullis, for which he later (1993) was awarded with the Nobel Prize in Chemistry along with Michael Smith [1]. The protocol is based on targeting specific DNA or rDNA sequences with more or less specific short tracer sequences (primers/oligonucleotides, colloquially oligos) binding to flanking regions of the core sequence to be proliferated. A succession of thermal incubation steps defined by length and temperature are cycled and conduct double-stranded DNA (dsDNA) melting, that is, separation of the target DNA into antiparallel, complementary, single-stranded DNA (ssDNA) strands, specific binding of primers (annealing), and enzymatic amplification out of the basic set of four nucleotide monomers of the sequence embedded. In continuation, the newly synthesized dsDNA copies, selected in length by the specific primer binding sites (PBSs), themselves serve as templates for further replication rounds, setting in motion a chain reaction in which the DNA template is exponentially amplified. The core enzyme is a DNA polymerase, which was heat-sensitive at time of invention but subsequently was destroyed at the melting temperature. To gain useful numbers of target copies, an expensive and time-consuming replacement of the enzyme was needed at the beginning of each of the usually 20-40 replication cycles. The discovery of an extraordinarily thermostable DNA polymerase purified from the thermophilic bacterium Thermophilus aquaticus, which naturally lives in hot (50-80 ∘ C) environments such as hot springs [2], Modern Techniques for Pathogen Detection, First Edition. Edited by Jürgen Popp and Michael Bauer.

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“…Inzwischen erh ä ltliche Sepsistests (VYOO) mit erh ö hter Spezifi t ä t durch eine initiale Anreicherung bakterieller und fungaler DNA in der Punktatfl ü ssigkeit sollen das diagnostische Fenster diesbez ü glich schlie ß en k ö nnen. [45] Die Ausz ä hlung neutrophiler Granulozyten im Zusammenhang mit intraoperativ entnommener Gewebeprobe zeigt sich mit ü ber 90 % sehr spezifi sch. Ein hochgradiger Verdacht f ü r eine Infektion liegt bei > 5 Granulozyten pro Gesichtsfeld (high powerfi eld) vor.…”

Section: Diagnosesicherungunclassified

Notfälle in der Rheumatologie – Die Sicht des internistischen und orthopädischen Rheumatologen

Arnold

Andresen

2010

Akt Rheumatol

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▼Medical emergencies due to rheumatoid arthritis (RA) and ankylosing spondylitis (AS) can occur as a result of vasculitis, spinal instability, increased risk of fracture, tenosynovialitis with subsequent tendon rupture and septic arthritis. Structural changes in the cervical spine in long-standing RA render the joint facets and ligaments unstable. These patients are at high risk to develop neurological damage including myelopathy due to a narrowing of the spinal canal. Once neurological defi cits occur, surgical treatment is generally indicated. Even minor injuries can cause fractures, especially in the thoracic spinal column as the most susceptible part. Because conventional Xray images may not reveal these fractures, CT scans or MRI may be indicated. Neurological deteoration requires immediate surgical treatment. Also in RA, infl ammation and glucocorticoidinduced osteoporosis increase the risk of fractures, including periprosthetic fractures. Surgical options are often demanding due to the reduced bone structure. Tendon ruptures on exposed bone structures and regions of high mechanical wear in the hand and foot need reconstructive surgery in a timely manner. Septic arthritis is a disabling and potentially life-threatening condition that requires prompt diagnosis and treatment. Aspiration and culture of synovial fl uid are crucial for the diagnosis. Immediate antibiotic treatment, initially intravenously and then orally for sometimes prolonged periods of time as well as either arthroscopic intervention or open synovectomy are necessary.Heruntergeladen von: University of Pittsburgh. Urheberrechtlich geschützt.

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Applications of molecular pathology in the diagnosis of joint infections

Cited by 30 publications

References 37 publications

Die komplizierte Gicht

Die komplizierte Gicht

Nucleic Acid Amplification Techniques

Notfälle in der Rheumatologie – Die Sicht des internistischen und orthopädischen Rheumatologen

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