Authors: Johannes P Borde Georg A Häcker Sina Guschl Annerose Serr Tobias Danner Johannes Hübner Sandra BurrackLange Gerd Lüdke Peter Helwig Oliver Hauschild Winfried V Kern
Publish Date: 2015/05/29
Volume: 43, Issue: 5, Pages: 551-560
Abstract
Prosthetic joint infections PJI are associated with high morbidity and costs Various efforts have been made to improve the diagnosis of PJI over the past years but only few studies have assessed the diagnostic utility of nucleic acid amplification test NAAT techniques in this context Here we report our experience with a commercial 16S rRNA gene PCR and an automated multiplexPCR cartridge system in identifying pathogens causing PJIA prospective singlecentre study was performed including 54 patients with either septic or aseptic prosthetic joint replacement or surgical revision between February 2012 and April 2013 Conventional cultures of periprosthetic tissue samples were compared with the results of broadrange 16S rRNA gene realtime PCR UMDUniversal Pathogen DNA Extraction and PCR Analysis Molzym GmbH Germany and the multiplexPCR Unyvero ITI® cartridge system UITI Curetis AG Germany Conventional culture and broadrange 16S rRNA gene realtime PCR were performed on all samples UITI was used in a subgroup of 28 cases including all culturepositive cases The agreement of the results from the methods was assessedOf 54 cases seven were culturepositive Broadrange 16S rRNA gene realtime PCR gave 6 UITI 3 concordant positive results Of the 47 culturenegative samples 46 were also negative by broadrange 16S rRNA gene realtime PCR resulting in a 96 52/54 agreement between 16S rRNA gene PCR and culture Of the 21 culturenegative samples analysed with UITI 20 gave negative results including the single 16S rRNA gene PCRpositive/culturenegative specimen The rate of agreement between UITI and culture results was 82 23/28This pilot study gave no indication of superiority of the used NAATs over conventional culture methods for the microbiological diagnosis of PJI Drawbacks are susceptibility to contamination in the case of 16S rRNA gene realtime PCR labourintensive DNA extraction and limited pathogen panel in the case of the multiplex cartridge PCR system More prospective trials are needed to evaluate the diagnostic performance of NAATs and their impact on the clinical management of PJI
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