Titre
Improved diagnosis of periprosthetic joint infection by multiplex PCR of sonication fluid from removed implants.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Achermann, Yvonne
Auteure/Auteur
Vogt, Markus
Auteure/Auteur
Leunig, Michael
Auteure/Auteur
Wuest, Juerg
Auteure/Auteur
Trampuz, Andrej
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1098-660X[electronic], 0095-1137[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
48
Numéro
4
Première page
1208
Dernière page/numéro d’article
1214
Langue
anglais
Résumé
The microbiological diagnosis of periprosthetic joint infection (PJI) is crucial for successful antimicrobial treatment. Cultures have limited sensitivity, especially in patients receiving antibiotics. We evaluated the value of multiplex PCR for detection of microbial DNA in sonication fluid from removed orthopedic prostheses. Cases of PJI in which the prosthesis (or part of it) was removed were prospectively included. The removed implant was sonicated, and the resulting sonication fluid was cultured and subjected to multiplex PCR. Of 37 PJI cases (17 hip prostheses, 14 knee prostheses, 4 shoulder prostheses, 1 elbow prosthesis, and 1 ankle prosthesis), pathogens were identified in periprosthetic tissue in 24 (65%) cases, in sonication fluid in 23 (62%) cases, and by multiplex PCR in 29 (78%) cases. The pathogen was detected in 5 cases in sonication fluid only (Propionibacterium acnes in all cases; none of these patients had previously received antibiotics) and in 11 cases by multiplex PCR only (all of these patients had previously received antibiotics). After exclusion of 8 cases caused by P. acnes or Corynebacterium species, which cannot be detected due to the absence of specific primers in the PCR kit, sonication cultures were positive in 17 cases and multiplex PCR sonication cultures were positive in 29 cases (59% versus 100%, respectively; P < 0.01). Among 19 cases (51%) receiving antibiotics, multiplex PCR was positive in all 19 (100%), whereas sonication cultures grew the organism in 8 (42%) (P < 0.01). Multiplex PCR of sonication fluid is a promising test for diagnosis of PJI, particularly in patients who previously received antibiotics. With modified primer sets, multiplex PCR has the potential for further improvement of the diagnosis of PJI.
PID Serval
serval:BIB_E066530A3E59
PMID
Open Access
Oui
Date de création
2010-04-21T08:43:41.758Z
Date de création dans IRIS
2025-05-21T05:26:59Z