Are There Benefits In Early Diagnosis Of Prosthetic Joint Infection With Multiplex Polymerase Chain Reaction?
| العنوان: | Are There Benefits In Early Diagnosis Of Prosthetic Joint Infection With Multiplex Polymerase Chain Reaction? |
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| المؤلفون: | Christian Lausmann, Julian Brañes, Lars Frommelt, Thorsten Gehrke, Mustafa Citak, Matthias Gebauer, Akos Zahar, Stefan Schmidl |
| المصدر: | Journal of Bone and Joint Infection, Vol 2, Pp 175-183 (2017) Journal of Bone and Joint Infection |
| بيانات النشر: | Copernicus GmbH, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | medicine.medical_specialty, Microbiological culture, diagnosis, medicine.drug_class, polymerase chain reaction, Antibiotics, Aseptic loosening, Periprosthetic, susceptibility, law.invention, 03 medical and health sciences, 0302 clinical medicine, lcsh:Orthopedic surgery, law, Internal medicine, Multiplex polymerase chain reaction, medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, prosthetic joint infection, bacteria, Polymerase chain reaction, 030222 orthopedics, business.industry, Prosthetic joint infection, revision arthroplasty, medicine.disease, Systemic inflammatory response syndrome, lcsh:RD701-811, Infectious Diseases, Surgery, business, Research Paper |
| الوصف: | Purpose Identification of bacteria and susceptibility are fundamental in periprosthetic joint infection (PJI). Especially in the case of systemic inflammatory response syndrome (SIRS) rapid detection of pathogens is essential for proper therapy. Bacterial cultures are time consuming. The polymerase chain reaction (PCR) is a non-culture molecular method and is able to rapidly identify pathogens and their resistance genes. Multiplex PCR (mPCR) can amplify several different DNA sequences simultaneously. The aim of this study was to show the value of mPCR for early diagnosis of PJI.Methods 60 patients undergoing total hip or knee revisions were recruited in this prospective single-centre-study. Three groups were created: 26 patients with aseptic loosening (negative control), 26 patients with chronic PJI, and 8 patients with acute PJI/SIRS. We compared the results of joint aspirates obtained intraoperatively investigated by mPCR with the microbiology results of tissue specimens.Results The overall sensitivity of mPCR was 78.8% (95% CI, 61.1 - 91.0%), the specificity was 100% (95% CI, 87.2 - 100%), the negative predictive value was 79.4% (95% CI, 62.1 - 91.3%), the positive predictive value was 100% (95% CI, 86.8 - 100%), and the overall accuracy was 88.3% (95% CI, 77.4 - 95.2%). The overall accuracy in acute infections/SIRS (87.5%) was greater than in late chronic PJI (76.9%). In PJI the mPCR was able to provide the results within 5 hours whereas the mean time for cultures was 6.4 days.Conclusions Multiplex PCR is a reliable diagnostic tool in PJI management, especially in acute cases complicated with SIRS. Early diagnosis within several hours is possible, targeted antibiotic treatment can be started promptly. |
| تدمد: | 2206-3552 |
| DOI: | 10.7150/jbji.22062 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::661b5ed3971a8b835a5853dc34d8553f https://doi.org/10.7150/jbji.22062 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....661b5ed3971a8b835a5853dc34d8553f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 22063552 |
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| DOI: | 10.7150/jbji.22062 |