Meta-analysis of synovial fluid polymerase chain reaction for diagnosing periprosthetic hip and knee infection

Abstract Background and objective The purpose of this study was to estimate the diagnostic performance of synovial fluid polymerase chain reaction (PCR) in periprosthetic hip and knee infection, and whether synovial fluid PCR has greater diagnostic significance than conventional methods. Methods The literature databases PubMed, Scopus, and the Web of Science were searched for English articles describing periprosthetic joint infection (PJI) diagnosis by synovial fluid PCR. Articles were limited to the period between January 1990 and December 2019. Subsequently, conventional methods that were used on at least two occasions were included for further analysis. Data analysis was performed using the Meta-DiSc and Stata software. Results Eleven studies with 1360 cases were included in the meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of synovial fluid PCR were 0.70 (95% CI 0.66–0.74), 0.92 (95% CI 0.90–0.93), and 37.4 (95% CI 17.77–78.74), respectively. Conclusions Synovial fluid PCR provides an effective tool for rapid diagnosis of PJI, and also in the early stages of culture-negative bacterial infections.

Download Full-text

Meta-Analysis of Synovial Fluid Polymerase Chain Reaction for Diagnosing Periprosthetic Hip and Knee Infection

10.21203/rs.3.rs-564463/v1 ◽

2021 ◽

Author(s):

Cheng Li ◽

Hao Li ◽

Xue Yang ◽

Fang-Zheng Zhu ◽

Chi Xu ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Synovial Fluid ◽

Meta Analysis ◽

Joint Infection ◽

Chain Reaction ◽

Diagnostic Significance ◽

Knee Infection ◽

Suspected Infection ◽

Polymerase Chain ◽

Conventional Methods

Abstract BACKGROUND AND OBJECTIVE: The purpose of this study was to estimate the diagnostic performance of synovial fluid polymerase chain reaction (PCR) in periprosthetic hip and knee infection, and whether synovial fluid PCR has greater diagnostic significance than conventional methods.METHODS: The literature databases PubMed, Scopus, and the Web of Science were searched for English articles describing periprosthetic joint infection (PJI) diagnosis by synovial fluid PCR. Articles were limited to the period between January 1990 and December 2019. Subsequently, conventional methods that were used on at least two occasions were included for further analysis. Data analysis was performed using the Meta-DiSc and Stata software.RESULTS: Eleven studies with 1360 cases were included in the meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of synovial fluid PCR were 0.70 (95% CI: 0.66–0.74), 0.92 (95% CI: 0.90–0.93), and 37.4 (95% CI: 17.77–78.74), respectively. CONCLUSIONS: Synovial fluid PCR can be used as a diagnostic confirmatory method for PJI in cases of negative synovial fluid culture with highly suspected infection during the early stages.

Download Full-text

Rapid detection of periprosthetic joint infection using a combination of 16s rDNA polymerase chain reaction and lateral flow immunoassay

Bone and Joint Research ◽

10.1302/2046-3758.71.bjr-2017-0103.r2 ◽

2018 ◽

Vol 7 (1) ◽

pp. 12-19 ◽

Cited By ~ 18

Author(s):

V. Janz ◽

J. Schoon ◽

C. Morgenstern ◽

B. Preininger ◽

S. Reinke ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Synovial Fluid ◽

16S Rdna ◽

Periprosthetic Joint Infection ◽

Bacterial Species ◽

Joint Infection ◽

Lateral Flow Immunoassay ◽

Chain Reaction ◽

Polymerase Chain ◽

Proof Of Principle

Objectives The objective of this study was to develop a test for the rapid (within 25 minutes) intraoperative detection of bacteria from synovial fluid to diagnose periprosthetic joint infection (PJI). Methods The 16s rDNA test combines a polymerase chain reaction (PCR) for amplification of 16s rDNA with a lateral flow immunoassay in one fully automated system. The synovial fluid of 77 patients undergoing joint aspiration or primary or revision total hip or knee surgery was prospectively collected. The cohort was divided into a proof-of-principle cohort (n = 17) and a validation cohort (n = 60). Using the proof-of-principle cohort, an optimal cut-off for the discrimination between PJI and non-PJI samples was determined. PJI was defined as detection of the same bacterial species in a minimum of two microbiological samples, positive histology, and presence of a sinus tract or intra-articular pus. Results The 16s rDNA test proved to be very robust and was able to provide a result in 97% of all samples within 25 minutes. The 16s rDNA test was able to diagnose PJI with a sensitivity of 87.5% and 82%, and a specificity of 100% and 89%, in the proof-of-principle and validation cohorts, respectively. The microbiological culture of synovial fluid achieved a sensitivity of 80% and a specificity of 93% in the validation cohort. Conclusion The 16s rDNA test offers reliable intraoperative detection of all bacterial species within 25 minutes with a sensitivity and specificity comparable with those of conventional microbiological culture of synovial fluid for the detection of PJI. The 16s rDNA test performance is independent of possible blood contamination, culture time and bacterial species. Cite this article: V. Janz, J. Schoon, C. Morgenstern, B. Preininger, S. Reinke, G. Duda, A. Breitbach, C. F. Perka, S. Geissler. Rapid detection of periprosthetic joint infection using a combination of 16s rDNA polymerase chain reaction and lateral flow immunoassay: A Pilot Study. Bone Joint Res 2018;7:12–19. DOI: 10.1302/2046-3758.71.BJR-2017-0103.R2.

Download Full-text

Diagnosis of Periprosthetic Joint Infection Using Polymerase Chain Reaction: An Updated Systematic Review and Meta-Analysis

Surgical Infections ◽

10.1089/sur.2018.014 ◽

2018 ◽

Vol 19 (6) ◽

pp. 555-565 ◽

Cited By ~ 10

Author(s):

Yang Jun ◽

Liu Jianghua

Keyword(s):

Systematic Review ◽

Polymerase Chain Reaction ◽

Periprosthetic Joint Infection ◽

Meta Analysis ◽

Joint Infection ◽

Chain Reaction ◽

Polymerase Chain

Download Full-text

Evaluation of diagnostic accuracy of loop-mediated isothermal amplification method (LAMP) compared with polymerase chain reaction (PCR) for Leptospira spp. in clinical samples: a systematic review and meta-analysis

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2021.115369 ◽

2021 ◽

Vol 100 (3) ◽

pp. 115369

Author(s):

Shan Gunasegar ◽

Vasantha Kumari Neela

Keyword(s):

Systematic Review ◽

Polymerase Chain Reaction ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Isothermal Amplification ◽

Clinical Samples ◽

Chain Reaction ◽

Amplification Method ◽

Leptospira Spp ◽

Polymerase Chain

Download Full-text

A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

Scientific Reports ◽

10.1038/s41598-020-80061-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Fatemeh Khatami ◽

Mohammad Saatchi ◽

Seyed Saeed Tamehri Zadeh ◽

Zahra Sadat Aghamir ◽

Alireza Namazi Shabestari ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcriptase ◽

Ct Scan ◽

Predictive Value ◽

Meta Analysis ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Chest Ct Scan

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.

Download Full-text