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

2018 ◽  
Vol 7 (1) ◽  
pp. 12-19 ◽  
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.

Commercially Available Polymerase Chain Reaction Has Minimal Utility in the Diagnosis of Periprosthetic Joint Infection

Orthopedics ◽  
2020 ◽  
Vol 43 (6) ◽  
pp. 333-338
Author(s):  
Beau J. Kildow ◽  
Sean P. Ryan ◽  
Richard Danilkowicz ◽  
Alexander L. Lazarides ◽  
Tyler J. Vovos ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Chain Reaction ◽  
Polymerase Chain

scholarly journals Higher sensitivity of swab polymerase chain reaction compared with tissue cultures for diagnosing periprosthetic joint infection

2018 ◽  
Vol 26 (1) ◽  
pp. 230949901876529 ◽  
Author(s):  
Mohamed Omar ◽  
Maximilian Petri ◽  
Nael Hawi ◽  
Christian Krettek ◽  
Jörg Eberhard ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Tissue Cultures ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Higher Sensitivity

A new multiplex real-time polymerase chain reaction assay for the diagnosis of periprosthetic joint infection

2017 ◽  
Vol 27 (6) ◽  
pp. 1072-1078 ◽  
Author(s):  
Masaki Kawamura ◽  
Naomi Kobayashi ◽  
Yutaka Inaba ◽  
Hyonmin Choe ◽  
Taro Tezuka ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Real Time ◽  
Periprosthetic Joint Infection ◽  
Polymerase Chain Reaction Assay ◽  
Joint Infection ◽  
Chain Reaction ◽  
Polymerase Chain

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

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Cheng Li ◽  
Hao Li ◽  
Xue Yang ◽  
Fang-Zheng Zhu ◽  
Chi Xu ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Synovial Fluid ◽  
Bacterial Infections ◽  
Meta Analysis ◽  
Joint Infection ◽  
Chain Reaction ◽  
Diagnostic Significance ◽  
Knee 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 provides an effective tool for rapid diagnosis of PJI, and also in the early stages of culture-negative bacterial infections.

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

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.

scholarly journals Propidium monoazide–polymerase chain reaction for detection of residual periprosthetic joint infection in two-stage revision

2019 ◽  
Vol 46 (6) ◽  
pp. 6463-6470
Author(s):  
Mohamed Askar ◽  
Mariam Sajid ◽  
Yassar Nassif ◽  
Waheed Ashraf ◽  
Brigitte Scammell ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Propidium Monoazide ◽  
Chain Reaction ◽  
Two Stage ◽  
Specific Primers ◽  
Musculoskeletal Infection ◽  
Cutibacterium Acnes ◽  
Polymerase Chain

Abstract False negative culture results in periprosthetic joint infection (PJI) are not uncommon particularly when patients have received long term antibiotics. Polymerase chain reaction (PCR) has a lower specificity partly due to detection of residual DNA from dead bacteria. Propidium monoazide (PMA) prevents DNA from dead bacteria from being amplified during the PCR. This study aimed to determine the role of PMA in PCR for diagnosis of PJI. Clinical samples were tested by PCR with and without prior treatment with PMA and compared to conventional microbiological culture. The PCR assay included genus-specific primers for staphylococci and enterococci and species-specific primers for Cutibacterium acnes. The validated conditions of PMA treatment used in this study were 20 μM concentration and 5 and 10 min of dark incubation and photo-activation respectively. 202 periprosthetic tissues and explanted prostheses from 60 episodes in 58 patients undergoing revision arthroplasties for either PJI or non-infective causes were tested, by culture, PCR, and PMA-PCR. 14 of the 60 episodes satisfied the Musculoskeletal Infection Society (MSIS) criteria for PJI and 46 did not. Sensitivity of culture, PCR, and PMA-PCR were 50%, 71%, and 79% respectively. Specificities were 98%, 72%, and 89% respectively. All figures were calculated for episodes rather than samples. PMA-PCR enhanced both the specificity and the sensitivity of PCR. It has the potential to detect residual bacterial viability prior to reimplantation in the two-stage revision for PJI.

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