The Use of Polymerase Chain Reaction for the Detection and Speciation of Bacterial Bone and Joint Infection in Children

Abstract

We evaluated 36 consecutive patients presenting with signs and symptoms of bacterial bone and joint infection and 10 control patients using bacterial cultures of blood and the presumed site of infection compared with polymerase chain reaction (PCR) techniques using a universal primer and restriction endonuclease digestion. Of the 28 patients with definitive clinical and/or laboratory evidence of bacterial infection, 16 patients had positive bacterial cultures and 12 were PCR-positive. Twenty of 28 patients were either PCR- or culture-positive. Nine of the 16 subjects who had culture-positive samples also had PCR-positive samples (8 positive for the same organism and 1 with 2 organisms identified by culture, but only a single organism by PCR. Six culture positive patients were PCR-negative. Of the 12 patients who were culture-negative, 4 had bacterial genomic material present indicating infection. We conclude that current PCR methods are not superior to standard bacterial culture methods when applied to children with presumed bone or joint infections, but that PCR may complement existing microbiologic cultures for detection of bone and joint infections in children.

Can early MRI distinguish between Kingella kingae and Gram-positive cocci in osteoarticular infections in young children?

“…This is in agreement with recent literature reporting that K. kingae should be considered the most frequent cause of OAI in children under 4 years old [6,16,18,30] in developed countries.…”

“…It requires high clinical alertness and cannot be ruled out in the absence of fever or by normal laboratory results [1]. Efficient treatment requires early diagnosis with identification of the causative organism [2][3][4], but this is only possible in 40-70% of paediatric OAIs [5][6][7] and even more difficult in children younger than 4 years [8] in developed countries. Staphylococcus aureus and Streptococcus species are reported to be the major pathogens of paediatric OAI [6,[9][10][11][12].…”

“…Efficient treatment requires early diagnosis with identification of the causative organism [2][3][4], but this is only possible in 40-70% of paediatric OAIs [5][6][7] and even more difficult in children younger than 4 years [8] in developed countries. Staphylococcus aureus and Streptococcus species are reported to be the major pathogens of paediatric OAI [6,[9][10][11][12]. However, recently, a Gram-negative bacillus, K. kingae, has been reported as a frequent causative organism in children under 4 years of age [4,[13][14][15][16].…”

Microbiological Culture Methods for Pediatric Musculoskeletal Infection

“…Anaerobic, fungal, and AFB cultures should only be used when there is a suspicion of penetrating inoculation, immunocompromise, or failed primary treatment. Finally, due to the challenges of bacterial identification in children with septic arthritis, supplemental techniques, including joint-fluid cell count, the sending of joint fluid in an aerobic blood culture bottle, and PCR, are worthwhile 13,14,17 .…”

The fate of suboptimal anastomosis after colon resection: an experimental study

“…[21][22][23][24] The PCR method has been found to be more sensitive than blood cultures for detecting bacterial presence in the blood of critically ill surgical patients. [7] The detection of bacterial DNA in the blood of patients with liver cirrhosis, acute pancreatitis, and major abdominal surgery has also been reported.…”