Molecular Diagnosis of Osteoarticular Implant-Associated Infection: Available Techniques and How We Can Use Them

Abstract

Despite recent advances during the last few years, microbiological diagnosis of prosthetic joint infections remains a challenge. Molecular biology techniques have been developed to try to overcome this problem, and recently, many of them have become available for many laboratories. Some of them, especially commercial multiplex PCR-based assays and universal 16S rDNA homemade PCR assays, are now available in many laboratories. Moreover, new technologies have appeared, especially metagenomics and next-generation sequencing. These techniques have demonstrated their potential in many studies but appear to be experimental at present. A few studies have evaluated the possible use of these methods in the clinical routine, and a review of the critical aspects for the selection of a molecular method (accuracy, complexity, cost) was performed. Finally, a proposal for a protocol that includes molecular biology techniques was made according to the literature published in this field. In conclusion, molecular biology techniques are ready to be used in the clinical routine of a microbiology laboratory, but their use must be carried out in accordance with the many special characteristics of each laboratory. In all cases, the interpretation of the results must be conducted by a multidisciplinary team with experience in the management of these patients.

Differences in In Vitro Bacterial Adherence between Ti6Al4V and CoCrMo Alloys

“…On the other hand, sometimes, no microorganisms can be detected in the culture (culture-negative infections). The knowledge of aetiology has improved with the use of modern molecular methods that allow the detection of non-culturable microorganisms, especially with the help of new molecular tools based on metagenomics and next-generation sequencing [ 9 ]. However, despite all the advances in microbiological diagnosis, most infections are still caused by a relatively small group of microorganisms.…”