Molecular Diagnostics for the Detection of Musculoskeletal Infection

Hoeffel, Daniel; Hinrichs, Steven H.; Garvin, Kevin L.

doi:10.1097/00003086-199903000-00007

Cited by 52 publications

(37 citation statements)

References 26 publications

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“…Several researchers have evaluated the role of PCR in the diagnosis of osteoarticular infections, including septic arthritis (8,14,15) and PJI (1a, 4, 5, 12, 17, 25). The value of PCR was mainly investigated in synovial fluid or periprosthetic tissue specimens, whereas sonication fluid was evaluated only recently (18,26).…”

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confidence: 99%

Improved Diagnosis of Periprosthetic Joint Infection by Multiplex PCR of Sonication Fluid from Removed Implants

et al. 2010

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The microbiological diagnosis of periprosthetic joint infection (PJI) is crucial for successful antimicrobial treatment. Cultures have limited sensitivity, especially in patients receiving antibiotics. We evaluated the value of multiplex PCR for detection of microbial DNA in sonication fluid from removed orthopedic prostheses. Cases of PJI in which the prosthesis (or part of it) was removed were prospectively included. The removed implant was sonicated, and the resulting sonication fluid was cultured and subjected to multiplex PCR. Of 37 PJI cases (17 hip prostheses, 14 knee prostheses, 4 shoulder prostheses, 1 elbow prosthesis, and 1 ankle prosthesis), pathogens were identified in periprosthetic tissue in 24 (65%) cases, in sonication fluid in 23 (62%) cases, and by multiplex PCR in 29 (78%) cases. The pathogen was detected in 5 cases in sonication fluid only (Propionibacterium acnes in all cases; none of these patients had previously received antibiotics) and in 11 cases by multiplex PCR only (all of these patients had previously received antibiotics). After exclusion of 8 cases caused by P. acnes or Corynebacterium species, which cannot be detected due to the absence of specific primers in the PCR kit, sonication cultures were positive in 17 cases and multiplex PCR sonication cultures were positive in 29 cases (59% versus 100%, respectively; P < 0.01). Among 19 cases (51%) receiving antibiotics, multiplex PCR was positive in all 19 (100%), whereas sonication cultures grew the organism in 8 (42%) (P < 0.01). Multiplex PCR of sonication fluid is a promising test for diagnosis of PJI, particularly in patients who previously received antibiotics. With modified primer sets, multiplex PCR has the potential for further improvement of the diagnosis of PJI.

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confidence: 99%

Improved Diagnosis of Periprosthetic Joint Infection by Multiplex PCR of Sonication Fluid from Removed Implants

et al. 2010

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“…A master mix without template DNA and DNase I nontreated by preincubation, showed in the second run of nested-PCR band corresponding to requested amplicon for detection of universal bacteria (287 bp long). After preincubation with 50 U of DNase I, this amplicon was (3,14), Streptococcus pyogenes (4,15), Streptococcus agalactiae (5,16), Enterococcus faecium (6,17), Enterococcus faecalis (7,18), Klebsiella pneumoniae (8,19), Escherichia coli (9,20), Proteus mirabilis (10,21), Pseudomonas aeruginosa (11,22), Serratia marcescens (12,23). …”

Section: Resultsmentioning

confidence: 99%

“…Hoeffel et al stressed the role of residual Escherichia coli DNA in commercially available products. 22 They attempted to eliminate this false-positive amplification by developing so-called genus focused PCR primers designed not to hybridize and amplify Escherichia coli 16S rRNA DNA. However, the results of this strategy were rather disillusioning (sensitivity 71 %, specificity 49 %).…”

Section: Discussionmentioning

confidence: 99%

Universal Primers for Detection of Common Bacterial Pathogens Causing Prosthetic Joint Infection

Šauer¹,

Gallo²,

Kesselová³

et al. 2005

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…A number of studies investigating the role of bacterial 16s rRNA PCR have been performed. Sensitivities of this technique ranged from 63-100% in detecting bacteria involved in prosthetic joint infection (De Man, et al 2009, Hoeffel, et al 1999, Mariani, et al 1996, Moojen, et al 2007). In a study by Mariani et al 50 patients with symptoms following total knee arthroplasty underwent synovial fluid and intraoperative tissue sampling for culture and PCR; cultures were positive in fifteen specimens compared to 32 specimens when PCR was applied (Mariani, et al 1996).…”

Section: Molecular Techniquesmentioning

confidence: 99%