Prosthetic joint infection diagnosis using broad-range PCR of biofilms dislodged from knee and hip arthroplasty surfaces using sonication

Periprosthetic tissue and/or synovial fluid PCR has been previously studied for prosthetic joint infection (PJI) diagnosis; however, few studies have assessed the utility of PCR on biofilms dislodged from the surface of explanted arthroplasties using vortexing and sonication (i.e., sonicate fluid PC...

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Vydáno v:	Journal of clinical microbiology Ročník 50; číslo 11; s. 3501
Hlavní autoři:	Gomez, Eric, Cazanave, Charles, Cunningham, Scott A, Greenwood-Quaintance, Kerryl E, Steckelberg, James M, Uhl, James R, Hanssen, Arlen D, Karau, Melissa J, Schmidt, Suzannah M, Osmon, Douglas R, Berbari, Elie F, Mandrekar, Jayawant, Patel, Robin
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States 01.11.2012
Témata:	Adult Aged Aged, 80 and over Arthroplasty - adverse effects Bacteria - classification Bacteria - genetics Bacteria - isolation & purification Bacterial Infections - diagnosis Bacterial Infections - microbiology Bacterial Physiological Phenomena Biofilms - growth & development Female Genes, rRNA Hip Joint Humans Knee Joint Male Middle Aged Polymerase Chain Reaction - methods Prostheses and Implants - microbiology Prosthesis-Related Infections - diagnosis Prosthesis-Related Infections - microbiology RNA, Ribosomal, 16S - genetics Sensitivity and Specificity Sonication - methods Young Adult
ISSN:	1098-660X, 1098-660X
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Shrnutí:	Periprosthetic tissue and/or synovial fluid PCR has been previously studied for prosthetic joint infection (PJI) diagnosis; however, few studies have assessed the utility of PCR on biofilms dislodged from the surface of explanted arthroplasties using vortexing and sonication (i.e., sonicate fluid PCR). We compared sonicate fluid 16S rRNA gene real-time PCR and sequencing to culture of synovial fluid, tissue, and sonicate fluid for the microbiologic diagnosis of PJI. PCR sequences generating mixed chromatograms were decatenated using RipSeq Mixed. We studied sonicate fluids from 135 and 231 subjects with PJI and aseptic failure, respectively. Synovial fluid, tissue, and sonicate fluid culture and sonicate fluid PCR had similar sensitivities (64.7, 70.4, 72.6, and 70.4%, respectively; P > 0.05) and specificities (96.9, 98.7, 98.3, and 97.8%, respectively; P > 0.05). Combining sonicate fluid culture and PCR, the sensitivity was higher (78.5%, P < 0.05) than those of individual tests, with similar specificity (97.0%). Thirteen subjects had positive sonicate fluid culture but negative PCR, and 11 had negative sonicate fluid culture but positive PCR (among which 7 had prior use of antimicrobials). Broad-range PCR and culture of sonicate fluid have equivalent performance for PJI diagnosis.
Bibliografie:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	1098-660X 1098-660X
DOI:	10.1128/JCM.00834-12