Wert der 16S rDNA Polymerase-Ketten-Reaktion (PCR) zur intraoperativen Infektdetektion bei Endoprothesenrevisionseingriffen

Kordelle, J.; Hossain, Hamid; Stahl, U.; Schleicher, I.; Haas, Holger

doi:10.1055/s-2004-832343

Cited by 11 publications

(1 citation statement)

References 11 publications

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“…They found a perfect compatibility between culture and PCR results in 475 of 525 samples (90.5%). Kordelle et al ( 40 ) sequenced the 16S rDNA amplicons and found 100% agreement between PCR and culture, but the study included only seven cases of PJI. In the present study, the universal 16S rDNA PCR technique was totally unhelpful for the bacterial identification.…”

Section: Discussionmentioning

confidence: 99%

Detection of Bacteria Bearing Resistant Biofilm Forms, by Using the Universal and Specific PCR is Still Unhelpful in the Diagnosis of Periprosthetic Joint Infections

et al. 2014

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Intraoperative conventional bacteriological cultures were compared with different polymerase chain reaction (PCR) methods in patients with total joint arthroplasties. The isolated bacteria were investigated for biofilm formation, and the biofilm forming strains, in their planktonic and biofilm forms, were further tested for their antimicrobial resistance against several clinically important antimicrobials. Forty four bone and joint samples were included and classified as infected or non-infected according to standard criteria for periprosthetic hip and knee infections. For the bacteriological diagnosis, conventional culture, two types of universal PCR and species specific PCR for three selected pathogens (Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa) were applied. Biofilm formation determination was performed by the tissue culture plate method. Antimicrobial susceptibility of the planktonic bacteria was performed by the minimal inhibitory concentration determination and, of the biofilm forms, by the minimal inhibitory concentration for bacterial regrowth from the biofilm. Twenty samples were culture positive, with S. epidermidis, S. aureus, or P. aeruginosa. All PCR methods were very ineffective in detecting only one pathogen. All isolates were biofilm positive and their biofilm forms, were highly resistant. In this study, compared to PCR, culture remains the “gold standard.” The biofilm formation by the causative bacteria and the concomitant manifold increased antimicrobial resistance may explain the clinical failure of treatment in some cases and should be considered in the future for therapeutic planning.

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Section: Discussionmentioning

confidence: 99%

Detection of Bacteria Bearing Resistant Biofilm Forms, by Using the Universal and Specific PCR is Still Unhelpful in the Diagnosis of Periprosthetic Joint Infections

et al. 2014

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Bone and Joint Infections

Gillespie

2009

Evidence‐Based Infectious Diseases

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Diagnostic strategies in cases of suspected periprosthetic infection of the knee

Gollwitzer

Diehl

Gerdesmeyer³

et al. 2006

Orthopäde

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Reliable confirmation of periprosthetic infection after total knee arthroplasty is a diagnostic challenge. The present work reviews published data evaluating the available diagnostic tools. Erythrocyte sedimentation rate and C-reactive protein serum levels are relatively sensitive methods with rather low specificity towards periprosthetic infection and are mainly applied to exclude infection. Studies evaluating scintigraphic methods--especially white cell scans--provide inconsistent data with varying accuracy. Consequently, white cell scans cannot be recommended as standard methods. Immunoscintigraphy with antigranulocyte antibodies and FDG-PET scans demonstrated promising results with particularly high sensitivities, but have to be validated in larger studies. Microbiological evaluation of joint aspirates proved high specificity for periprosthetic infection. However, an average of 20% of infected cases remained undetected. Nevertheless, aspiration is widely recommended for preoperative isolation of the infecting organism. Intraoperative frozen sections demonstrated excellent specificity with good sensitivity. The real accuracy of intraoperative culture and permanent histology cannot be determined due to the missing golden standard; however, a combination of both methods is recommended to define the final diagnosis. Large studies validating both methods and criteria for the final diagnosis of periprosthetic infection are necessary to optimize the diagnostic algorithm.

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Wert der 16S rDNA Polymerase-Ketten-Reaktion (PCR) zur intraoperativen Infektdetektion bei Endoprothesenrevisionseingriffen

Abstract: Although PCR is more rapidly available for the diagnosis of periprosthetic infection, a definite advantage of this more expensive method could not be demonstrated in view of the same low sensitivity of PCR and conventional bacterial culturing.

Cited by 11 publications

References 11 publications

Detection of Bacteria Bearing Resistant Biofilm Forms, by Using the Universal and Specific PCR is Still Unhelpful in the Diagnosis of Periprosthetic Joint Infections

Detection of Bacteria Bearing Resistant Biofilm Forms, by Using the Universal and Specific PCR is Still Unhelpful in the Diagnosis of Periprosthetic Joint Infections

Bone and Joint Infections

Diagnostic strategies in cases of suspected periprosthetic infection of the knee

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