Efficacy of a novel PCR- and microarray-based method in diagnosis of a prosthetic joint infection

Abstract

Background and purposePolymerase chain reaction (PCR) methods enable detection and species identification of many pathogens. We assessed the efficacy of a new PCR and microarray-based platform for detection of bacteria in prosthetic joint infections (PJIs).MethodsThis prospective study involved 61 suspected PJIs in hip and knee prostheses and 20 negative controls. 142 samples were analyzed by Prove-it Bone and Joint assay. The laboratory staff conducting the Prove-it analysis were not aware of the results of microbiological culture and clinical findings. The results of the analysis were compared with diagnosis of PJIs defined according to the Musculoskeletal Infection Society (MSIS) criteria and with the results of microbiological culture.Results38 of 61 suspected PJIs met the definition of PJI according to the MSIS criteria. Of the 38 patients, the PCR detected bacteria in 31 whereas bacterial culture was positive in 28 patients. 15 of the PJI patients were undergoing antimicrobial treatment as the samples for analysis were obtained. When antimicrobial treatment had lasted 4 days or more, PCR detected bacteria in 6 of the 9 patients, but positive cultures were noted in only 2 of the 9 patients. All PCR results for the controls were negative. Of the 61 suspected PJIs, there were false-positive PCR results in 6 cases.InterpretationThe Prove-it assay was helpful in PJI diagnostics during ongoing antimicrobial treatment. Without preceding treatment with antimicrobials, PCR and microarray-based assay did not appear to give any additional information over culture.

Do Crosslinking and Vitamin E Stabilization Influence Microbial Adhesions on UHMWPE-based Biomaterials?

“…Substantial effort is being made by biomaterial scientists to improve both in vivo performance and biomaterial resistance to microbial adhesion of crosslinked UHMWPE materials, but data about microbial adhesion on either crosslinked UHMWPE or vitamin E-added UHMWPE compared with conventional (gamma sterilized) or virgin (untreated) UHMWPE are scarce. In addition, the majority of studies have only evaluated the most commonly involved bacteria (Staphylococcus aureus, Staphylococcus epidermidis) and have not considered other relevant microorganisms that are potential sources of infection [14,22].…”

Revisionsendoprothetik

“…PCR-basierte Methoden vervollständigen das methodische Repertoire der histopathologischen Infektionsdiagnostik [11,13]. Diese Methoden ermöglichen eine direkte Keimspezifizierung (Genotypisierung).…”

“…Nativmaterial ist mit höherer Sensitivität und Spezifität der infektionspathologischen Diagnose verbunden. Es existieren allerdings neue methodische Ansätze, welche auch eine optimale molekulare Aufarbeitung von formalinfixierten und paraffineingebetteten Proben ermöglichen [13,19]. …”

Solid and Suspension Microarrays for Microbial Diagnostics

“…Profiling of the microbiota of healing wounds shows an association of Acinetobacter with wound failure, and enteric-associated flora with successful healing . The identification of prosthetic joint infection can be enhanced by molecular techniques such as 16S PCR sequencing, and a microarray-based assay enhances detection in patients previously treated with antibiotics (Metso et al, 2014).…”