scholarly journals The use of polymerase chain reaction in the diagnosis and management of prosthetic joint infections: a debatable issues at this time

2019 ◽  
Vol 5 (2) ◽  
pp. 362
Author(s):  
Temi Ogunleye ◽  
Marlina Ponce de Leon ◽  
Suresh J. Antony
Keyword(s):  
Polymerase Chain Reaction ◽  
High Sensitivity ◽  
Chain Reaction ◽  
Diagnosis And Management ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Polymerase Chain

<p class="abstract">Joint replacement surgery is increasing due to its success in decreasing pain and restoring function. Prosthetic joint infections (PJI) is one of the most detrimental complications of the surgery. These infections can either be acute or chronic and can be caused by a variety of organisms. Effective and efficient identification of the cause of infection is vital so that proper treatment can be provided. The use of polymerase chain reaction (PCR) is a possibility for diagnosis and management of PJI with a reduction in the use of incorrect antibiotics. This is due to its ability to quickly diagnosis viral, bacterial, rickettsia, mycobacterial, and protozoal infection in hours. It also has high sensitivity and specificity even with antimicrobial usage and biofilm production. However, more studies need to be done in order to be able to classify it as a possible gold standard.</p>

scholarly journals Benefits of Polymerase Chain Reaction Combined With Culture for the Diagnosis of Bone and Joint Infections: A Prospective Test Performance Study

2019 ◽  
Vol 6 (12) ◽  
Author(s):  
Hervé Jacquier ◽  
Vincent Fihman ◽  
Rishma Amarsy ◽  
Eric Vicaut ◽  
Valérie Bousson ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Control Group ◽  
Expert Committee ◽  
Chain Reaction ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
Independent Expert ◽  
Prosthetic Joint Infections ◽  
Polymerase Chain ◽  
Pcr Targeting

Abstract Background The microbiological diagnosis of bone and joint infections (BJI) currently relies on cultures, and the relevance of molecular methods is still debated. The aim of this study was to determine whether polymerase chain reaction (PCR) could improve the etiological diagnosis of BJI. Methods A prospective study was conducted during a 4-year period at Lariboisiere University Hospital (Paris, France), including patients with suspicion of infectious spondylodiscitis, septic arthritis, prosthetic joint infections, and respective noninfected groups. Clinical and radiological data were collected at inclusion and during follow-up. All samples were analyzed by conventional cultures and 16S ribosomal deoxyribonucleic acid (rDNA) gene (16S-PCR). Specific cultures and PCR targeting Mycobacterium tuberculosis were also performed for spondylodiscitis samples. Case records were subsequently analyzed by an independent expert committee to confirm or invalidate the suspicion of infection and definitively classify the patients in a case or control group. The sensitivity of the combination of culture and PCR was compared with culture alone. Results After expert committee analysis, 105 cases of BJI cases and 111 control patients were analyzed. The most common pathogens of BJI were staphylococci (30%), M tuberculosis (19%), and streptococci (14%). Adding PCR enhanced the sensitivity compared with culture alone (1) for the diagnosis of M tuberculosis spondylodiscitis (64.4% vs 42.2%; P &lt; .01) and (2) for nonstaphylococci BJI (81.6% vs 71.3%; P &lt; .01). It is interesting to note that 16S-PCR could detect BJI due to uncommon bacteria such as Mycoplasma and fastidious bacteria. Conclusions Our study showed the benefit of 16S-PCR and PCR targeting M tuberculosis as add-on tests in cases of suspected BJI.

scholarly journals Detecting the presence of bacterial RNA by polymerase chain reaction in low volumes of preoperatively aspirated synovial fluid from prosthetic joint infections

2020 ◽  
Vol 9 (5) ◽  
pp. 219-224
Author(s):  
B. Yang ◽  
X. Fang ◽  
Y. Cai ◽  
Z. Yu ◽  
W. Li ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Revision Surgery ◽  
Predictive Value ◽  
Quantitative Polymerase Chain Reaction ◽  
Joint Fluid ◽  
Chain Reaction ◽  
Musculoskeletal Infection ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Polymerase Chain

Aims Preoperative diagnosis is important for revision surgery after prosthetic joint infection (PJI). The purpose of our study was to determine whether reverse transcription-quantitative polymerase chain reaction (RT-qPCR), which is used to detect bacterial ribosomal RNA (rRNA) preoperatively, can reveal PJI in low volumes of aspirated fluid. Methods We acquired joint fluid samples (JFSs) by preoperative aspiration from patients who were suspected of having a PJI and failed arthroplasty; patients with preoperative JFS volumes less than 5 ml were enrolled. RNA-based polymerase chain reaction (PCR) and bacterial culture were performed, and diagnostic efficiency was compared between the two methods.According to established Musculoskeletal Infection Society (MSIS) criteria, 21 of the 33 included patients were diagnosed with PJI. Results RNA-based PCR exhibited 57.1% sensitivity, 91.7% specificity, 69.7% accuracy, 92.3% positive predictive value, and 55.0% negative predictive value. The corresponding values for culture were 28.6%, 83.3%, 48.5%, 75.0%, and 40.0%, respectively. A significantly higher sensitivity was thus obtained with the PCR method versus the culture method. Conclusion In situations in which only a small JFS volume can be acquired, RNA-based PCR analysis increases the utility of preoperative puncture for patients who require revision surgery due to suspected PJI. Cite this article: Bone Joint Res. 2020;9(5):219–224.

scholarly journals Real-time polymerase chain reaction for diagnosis and management of HIV-induced uveitis

2018 ◽  
Vol 66 (11) ◽  
pp. 1634
Author(s):  
S Sudharshan ◽  
JayaprathaR Selvaraj ◽  
LilyK Therese ◽  
MK Janani ◽  
Poongulali Selvamuthu ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Real Time ◽  
Chain Reaction ◽  
Diagnosis And Management ◽  
Polymerase Chain
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