Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissue
Background and purpose — The correct diagnosis of prosthetic joint infection (PJI) can be difficult because bacteria form a biofilm on the surface of the implant. The sensitivity of culture from sonication fluid is better than that from periprosthetic tissue, but no comparison studies using molecula...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2016-07-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.3109/17453674.2016.1165558 |
| _version_ | 1818501771810570240 |
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| author | Mitja Rak Martina KavčIč Rihard Trebše Andrej CőR |
| author_facet | Mitja Rak Martina KavčIč Rihard Trebše Andrej CőR |
| author_sort | Mitja Rak |
| collection | DOAJ |
| description | Background and purpose — The correct diagnosis of prosthetic joint infection (PJI) can be difficult because bacteria form a biofilm on the surface of the implant. The sensitivity of culture from sonication fluid is better than that from periprosthetic tissue, but no comparison studies using molecular methods on a large scale have been performed. We assessed whether periprosthetic tissue or sonication fluid should be used for molecular analysis. Patients and methods — Implant and tissue samples were retrieved from 87 patients who underwent revision operation of total knee or total hip arthroplasty. Both sample types were analyzed using broad-range (BR-) PCR targeting the 16S rRNA gene. The results were evaluated based on the definition of periprosthetic joint infection from the Workgroup of the Musculoskeletal Infection Society. Results — PJI was diagnosed in 29 patients, whereas aseptic failure was diagnosed in 58 patients. Analysis of sonication fluid using BR-PCR detected bacteria in 27 patients, whereas analysis of periprosthetic tissue by BR-PCR detected bacteria in 22 patients. In 6 of 7 patients in whom BR-PCR analysis of periprosthetic tissue was negative, low-virulence bacteria were present. The sensitivity and specificity values for periprosthetic tissue were 76% and 93%, respectively, and the sensitivity and specificity values for sonication fluid were 95% and 97%. Interpretation — Our results suggest that sonication fluid may be a more appropriate sample than periprosthetic tissue for BR-PCR analysis in patients with PJI. However, further investigation is required to improve detection of bacteria in patients with so-called aseptic failure. |
| first_indexed | 2024-12-10T21:00:49Z |
| format | Article |
| id | doaj.art-6ec2dc24ecb641528a4115ca176af8a2 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-12-10T21:00:49Z |
| publishDate | 2016-07-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-6ec2dc24ecb641528a4115ca176af8a22022-12-22T01:33:49ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822016-07-0187433934510.3109/17453674.2016.11655581165558Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissueMitja Rak0Martina KavčIč1Rihard Trebše2Andrej CőR3University of PrimorskaEnvironment and FoodValdoltra Orthopaedic HospitalUniversity of PrimorskaBackground and purpose — The correct diagnosis of prosthetic joint infection (PJI) can be difficult because bacteria form a biofilm on the surface of the implant. The sensitivity of culture from sonication fluid is better than that from periprosthetic tissue, but no comparison studies using molecular methods on a large scale have been performed. We assessed whether periprosthetic tissue or sonication fluid should be used for molecular analysis. Patients and methods — Implant and tissue samples were retrieved from 87 patients who underwent revision operation of total knee or total hip arthroplasty. Both sample types were analyzed using broad-range (BR-) PCR targeting the 16S rRNA gene. The results were evaluated based on the definition of periprosthetic joint infection from the Workgroup of the Musculoskeletal Infection Society. Results — PJI was diagnosed in 29 patients, whereas aseptic failure was diagnosed in 58 patients. Analysis of sonication fluid using BR-PCR detected bacteria in 27 patients, whereas analysis of periprosthetic tissue by BR-PCR detected bacteria in 22 patients. In 6 of 7 patients in whom BR-PCR analysis of periprosthetic tissue was negative, low-virulence bacteria were present. The sensitivity and specificity values for periprosthetic tissue were 76% and 93%, respectively, and the sensitivity and specificity values for sonication fluid were 95% and 97%. Interpretation — Our results suggest that sonication fluid may be a more appropriate sample than periprosthetic tissue for BR-PCR analysis in patients with PJI. However, further investigation is required to improve detection of bacteria in patients with so-called aseptic failure.http://dx.doi.org/10.3109/17453674.2016.1165558 |
| spellingShingle | Mitja Rak Martina KavčIč Rihard Trebše Andrej CőR Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissue Acta Orthopaedica |
| title | Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissue |
| title_full | Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissue |
| title_fullStr | Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissue |
| title_full_unstemmed | Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissue |
| title_short | Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissue |
| title_sort | detection of bacteria with molecular methods in prosthetic joint infection sonication fluid better than periprosthetic tissue |
| url | http://dx.doi.org/10.3109/17453674.2016.1165558 |
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