Is Xpert MRSA/SA SSTI real-time PCR a reliable tool for fast detection of methicillin-resistant coagulase-negative staphylococci in periprosthetic joint infections?

Lourtet-Hascoëtt, J.; Bicart‐See, A.; Félicé, M P; Giordano, G.; Bonnet, É.

doi:10.1016/j.diagmicrobio.2015.04.009

Cited by 19 publications

(13 citation statements)

References 23 publications

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“…We may combine with the use of procalcitonin and/or α-defensin as the marker of eradication of the infection 14 . A rapid polymerase-chain reaction (PCR) assay (ie Xpert® MRSA/SA ) also might be beneficial for assessment of intra-operative methicillin-resistant infection status 15,16 . All of those assays were not done in our centre, thus an overestimation of the eradication status may be occurred.…”

Section: Discussionmentioning

confidence: 99%

The Results of Two-stage Revision for Methicillin-resistant Periprosthetic Joint Infection (PJI) of the Hip

Santoso

et al. 2020

Malays Orthop J

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Introduction: Periprosthetic joint infection (PJI) of the hip due to methicillin-resistant bacteria is difficult to treat and remain a challenge for arthroplasty surgeon. Material and Methods: Retrospective review was done to the patients who received two-stage revisions with an antibiotic loaded cement-spacer for PJI of the hip between January 2010 to May 2015. We found 65 patients (65 hips) with positive culture findings. Eight patients were lost to follow-up and excluded from the study. Among the rest of the 57 patients, methicillin-resistant infection (MR Group) was found in 28 cases. We also evaluate the 29 other cases that caused by the other pathogen as control group. We compared all of the relevant medical records and the treatment outcomes between the two groups. Results: The mean of follow-up period was 33.7 months in the methicillin-resistant group and 28.4 months in the control group (p = 0.27). The causal pathogens in the methicillinresistant group were: Methicillin-resistant Staphylococcus aureus (MRSA) in 10 cases, Methicillin-resistant Staphylococcus epidermidis (MRSE) in 16 cases and Methicillin-resistant coagulase-negative Staphylococcus (MRCNS) in two cases. The reimplantation rate was 92.8% and 89.6% in the methicillin-resistant and control group, respectively (p= 0.66). The rates of recurrent infection after reimplantation were 23.1% (6/26) in the methicillin-resistant group and 7.6% (2/26) in the control group (p= 0.12). The overall infection control rate was 71.4% (20/28) and 89.6% (26/29) in the methicillin-resistant and control group, respectively (p = 0.08). Both groups showed comparable baseline data on mean age, BMI, gender distribution, preoperative ESR/CRP/WBC and comorbidities. Conclusions: Two-stage revision procedure resulted in low infection control rate and high infection recurrency rate for the treatment of methicillin-resistant periprosthetic joint infection (PJI) of the hip. Development of the treatment strategy is needed to improve the outcome of methicillinresistant periprosthetic joint infection (PJI) of the hip.

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Section: Discussionmentioning

confidence: 99%

The Results of Two-stage Revision for Methicillin-resistant Periprosthetic Joint Infection (PJI) of the Hip

Santoso

et al. 2020

Malays Orthop J

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“…Additionally in another study that used a method of using MRSA for fast detection of methicillin resistant coagulase negative Staphylococci in PJI, it was found that it lead to early microbial diagnosis but with low sensitivity and high cost. 34 In a meta-analysis that looked at several studies for the validity of PCR it was found that the sensitivity of 86% and specificity of 91% make it practical for clinical use. 35…”

Section: Pcr Usage In Synovial Fluidmentioning

confidence: 99%

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

Ogunleye¹,

Leon²,

Antony³

2019

Int J Res Orthop

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<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>

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“…Therefore, the correct diagnosis may be delayed if the clinical manifestations alone are depended upon, which may result in certain differences in various studies. This suggests that more rigorous methods are required for the early diagnosis of PJI (27,63). Even though the classification system used in the present review is universally used (2,25), specific disadvantages of this classification system are apparent.…”

Section: Agreement and Disagreement With Other Studiesmentioning

confidence: 99%

Distribution characteristics of Staphylococcus spp. in different phases of periprosthetic joint infection: A review

Guo

Wang

You

et al. 2017

Experimental and Therapeutic Medicine

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Periprosthetic joint infection (PJI) is a devastating condition and Staphylococcus spp. are the predominant pathogens responsible, particularly coagulase-negative staphylococci (CoNS) and Staphylococcus aureus. The aim of the present systematic review was to evaluate the distribution characteristics of specific Staphylococcus spp. in different PJI phases, reveal the effect of pathogens' feature on their distribution and suggest recommendations for antibiotic treatment of Staphylococcal PJI. The present systematic review was performed using PubMed and EMBASE databases with the aim to identify existing literature that presented the spectrum of Staphylococcus spp. that occur in PJI. Once inclusion and exclusion criteria were applied, 20 cohort studies involving 3,344 cases in 3,199 patients were included. The predominant pathogen involved in PJI was indicated to be CoNS (31.2%), followed by S. aureus (28.8%). This trend was more apparent in hip replacement procedures. In addition, almost equal proportions of CoNS and S. aureus (28.6 and 30.0%, respectively) were indicated in the delayed phase. CoNS (36.6%) were the predominant identified organism in the early phase, whereas S. aureus (38.3%) occurred primarily in the late phase. In PJI caused by S. aureus, the number of cases of methicillin-sensitive Staphylococcus aureus (MSSA) was ~2.5-fold greater than that of methicillin-resistant Staphylococcus aureus (MRSA). MRSA occurred predominantly in the early phase, whereas MSSA was largely observed in the delayed and late phases. With regards to antibiotic treatment, the feature of various pathogens and the phases of PJI were the primary considerations. The present review provides useful information for clinical practice and scientific research of PJI.

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Is Xpert MRSA/SA SSTI real-time PCR a reliable tool for fast detection of methicillin-resistant coagulase-negative staphylococci in periprosthetic joint infections?

Cited by 19 publications

References 23 publications

The Results of Two-stage Revision for Methicillin-resistant Periprosthetic Joint Infection (PJI) of the Hip

The Results of Two-stage Revision for Methicillin-resistant Periprosthetic Joint Infection (PJI) of the Hip

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

Distribution characteristics of Staphylococcus spp. in different phases of periprosthetic joint infection: A review

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