Contribution of a multiplex serological test for the preoperative diagnosis of prosthetic joint infection: a prospective study

Seynes, Camille de; Barbeyrac, Bertille de; Dutronc, H.; Ribes, Christopher; Cremer, Paul; Dubois, Véronique; Fabre, Thierry; Dupon, M.; Dauchy, Frédéric‐Antoine

doi:10.1080/23744235.2018.1453945

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…The sensitivity and specificity of the detection of anti-staphylococcal antibodies in our study are close to those reported by Marmor et al (72.3% and 80.7%, respectively) and lower than those reported by De Seynes et al (87.5% and 93.5%, respectively) [9,10]. The specificity is notably lower than that reported by De Seynes et al with the high number of positive serological reactions among uninfected patients (18.1%) in our study.…”

Section: Discussionsupporting

confidence: 88%

“…Patients were distributed evenly between PJI and mechanical problems. All PJIs were chronic, with the presence of a sinus tract in a third of cases and a significantly increased CRP level, which reinforces the importance of measuring CRP in the diagnosis of PJI [7][8][9][10].…”

Section: Discussionsupporting

confidence: 56%

“…The preliminary prospective study showed variable performance for detection, with a sensitivity and specificity of 72.3% and 80.7%, respectively for staphylococci, 75% and 92.6%, respectively, for S. agalactiae, and 38.5% and 84.8%, respectively for C. acnes [9]. The results reported in the second study for the sensitivity, specificity, positive and negative predictive values were 81.8%, 95.4%, 97.3% and 72.4%, respectively, for all patients and 87.5%, 93.5%, 94.6% and 85.3%, respectively, for staphylococcal infections [10].…”

Section: Introductionmentioning

confidence: 63%

“…Two recent studies have evaluated its contribution to the diagnosis of chronic PJIs [9,10]. The original study for the development and the evaluation of the test included 455 patients in 2 referral centres for complex osteoarticular infections, 176 PJIs and 279 uninfected patients [9].…”

Section: Introductionmentioning

confidence: 99%

“…The original study for the development and the evaluation of the test included 455 patients in 2 referral centres for complex osteoarticular infections, 176 PJIs and 279 uninfected patients [9]. The second prospective, single-centre study included 71 patients, 26 with aseptic failure and 45 with PJI in another referral centre for complex osteoarticular infections [10]. The preliminary prospective study showed variable performance for detection, with a sensitivity and specificity of 72.3% and 80.7%, respectively for staphylococci, 75% and 92.6%, respectively, for S. agalactiae, and 38.5% and 84.8%, respectively for C. acnes [9].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of a Multiplex Serological Test for the Diagnosis of Prosthetic Joint Infection: a Prospective Multicentre Study

Bémer¹,

Bourigault

Jolivet‐Gougeon

et al. 2020

J. Bone Joint Infect.

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Introduction:The diagnosis of prosthetic joint infections (PJIs) can be difficult in the chronic stage and is based on clinical and paraclinical evidence. A minimally invasive serological test against the main pathogens encountered during PJI would distinguish PJI from mechanical loosening. Methods: We performed a prospective, multicentre, cross-sectional study to assess the contribution of serology in the diagnosis of PJI. Over a 2-year period, all patients undergoing prosthesis revision were included in the study. A C-reactive protein assay and a serological test specifically designed against 5 bacterial species (Staphylococcus aureus, S. epidermidis, S. lugdunensis, Streptococcus agalactiae, Cutibacterium acnes) were performed preoperatively. Five samples per patient were taken intraoperatively during surgery. The diagnosis of PJI was based on clinical and bacteriological criteria according to guidelines. Results: Between November 2015 and November 2017, 115 patients were included, 49 for a chronic PJI and 66 for a mechanical problem. Among patients with PJI, a sinus tract was observed in 32.6% and a C-reactive protein level ≥10 mg/L in 74.5%. The PJI was monomicrobial in 43 cases (targeted staphylococci, 24; S. agalactiae, 1; C. acnes, 2; others, 16), and polymicrobial in 6 cases (12.2%). Sensitivity, specificity, positive predictive value and negative predictive value were 75.0%, 82.1%, 58.3% and 90.8%, respectively, for targeted staphylococci. Specificity/negative predictive value was 97.3%/100% for S. agalactiae and 83.8% /96.9% for C. acnes. Conclusions: The serological tests are insufficient to affirm the diagnosis of PJI for the targeted bacteria. Nevertheless, the excellent NPV may help clinicians to exclude PJI.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of a Multiplex Serological Test for the Diagnosis of Prosthetic Joint Infection: a Prospective Multicentre Study

Bémer¹,

Bourigault

Jolivet‐Gougeon

et al. 2020

J. Bone Joint Infect.

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Investigation of the pathogen-specific antibody response in periprosthetic joint infection

Janz,

Rakow,

Schröder

et al. 2024

Infection

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Purpose Periprosthetic joint infections (PJIs) are a very demanding complication of arthroplasty. Diagnosis of PJI and pathogen identification pose considerable challenges in clinical practice. We hypothesized that the pathogen-specific immune response to PJI reflects the infection process, provides clinically relevant information on disease course, and has the potential to further optimize antimicrobial therapy. Methods We conducted a prospective matched cohort pilot study with 13 patients undergoing two-stage septic revision arthroplasty (PJI patients) between 06/2020 and 06/2021, as well as 11 control patients undergoing one-stage aseptic revision arthroplasty (Non-PJI patients). Pre-, intra- and postoperative serum samples were collected at standardized time points. We developed a custom Luminex®-based quantitative bead-based suspension array (Infection Array; IA), and used it for simultaneous measurement of antibody specificities against 32 pathogens commonly associated with PJI in 267 serum samples. Results The IA was able to trace the dynamics of the pathogen-specific humoral immune response in all patients against PJI-related pathogens, prominently coagulase-negative staphylococci and streptococci. Pathogen-specific serum antibody titers declined in 62% of PJI patients over the course of treatment, while no changes in antibody titers were observed in 82% of Non-PJI patients during this study. Our serological data strongly suggested that antibody signatures reflect an immune response to microbial invasion. Conclusion Our results provide insights into the pathophysiology of PJI and information on the individual disease courses. The IA is therefore a promising and novel serological tool of high resolution for monitoring the immunoproteomic footprints of infectious pathogens in the course of PJI.

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Diagnostic accuracy of the BJI InoPlex™ (Diaxonhit) immunoassay on blood samples for periprosthetic joint infection in complex microbiological situations. Preliminary results of 24 cases in a French Reference Center for Complex Bone and Joint Infection (CRIOAC)

Dartus¹,

Martinot²,

Leclerc³

et al. 2021

Orthopaedics & Traumatology: Surgery & Research

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Contribution of a multiplex serological test for the preoperative diagnosis of prosthetic joint infection: a prospective study

Abstract: Multiplex serological test performed well among patients with chronic staphylococcal prosthetic infection. This approach could contribute to PJI diagnosis especially in patients for whom the pre-operative analysis of joint fluid is not informative.

Cited by 7 publications

References 19 publications

Assessment of a Multiplex Serological Test for the Diagnosis of Prosthetic Joint Infection: a Prospective Multicentre Study

Assessment of a Multiplex Serological Test for the Diagnosis of Prosthetic Joint Infection: a Prospective Multicentre Study

Investigation of the pathogen-specific antibody response in periprosthetic joint infection

Diagnostic accuracy of the BJI InoPlex™ (Diaxonhit) immunoassay on blood samples for periprosthetic joint infection in complex microbiological situations. Preliminary results of 24 cases in a French Reference Center for Complex Bone and Joint Infection (CRIOAC)

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