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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Bibliographic Details
Published in:Journal of clinical microbiology Vol. 50; no. 11; p. 3501
Main Authors: 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
Format: Journal Article
Language:English
Published: United States 01.11.2012
Subjects:
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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Summary: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.
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ISSN:1098-660X
1098-660X
DOI:10.1128/JCM.00834-12