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Utility of 16S rRNA PCR in the Synovial Fluid for the Diagnosis of Prosthetic Joint Infection

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초록

Conventional culture has been the mainstay for diagnosing prosthetic joint infections (PJIs), with synovial fluid and periprosthetic tissue samples being the preferred sample types [1]. However, culture-based methods often give false-negative results in patients with a high likelihood of PJI [2]. To overcome the limitations of culture methods, molecular techniques like universal 16S rRNA gene and pathogen-specific PCRs were developed for PJI diagnosis [2, 3]. Although PCR assays have shown satisfactory results in tests of periprosthetic tissue samples and sonication fluid, the diagnostic utility of PCR is less clear in tests of the synovial fluid [2-4]. Most studies that evaluated the utility of 16S rRNA PCR in the synovial fluid for diagnosing PJI have not used the Musculoskeletal Infection Society (MSIS) consensus criteria as the gold standard for PJI [2, 5]. Therefore, we evaluated the utility of 16S rRNA PCR in the synovial fluid for diagnosing PJI using MSIS criteria.

Abstract

Conventional culture has been the mainstay for diagnosing prosthetic joint infections (PJIs), with synovial fluid and periprosthetic tissue samples being the preferred sample types [1]. However, culture-based methods often give false-negative results in patients with a high likelihood of PJI [2]. To overcome the limitations of culture methods, molecular techniques like universal 16S rRNA gene and pathogen-specific PCRs were developed for PJI diagnosis [2, 3]. Although PCR assays have shown satisfactory results in tests of periprosthetic tissue samples and sonication fluid, the diagnostic utility of PCR is less clear in tests of the synovial fluid [2-4]. Most studies that evaluated the utility of 16S rRNA PCR in the synovial fluid for diagnosing PJI have not used the Musculoskeletal Infection Society (MSIS) consensus criteria as the gold standard for PJI [2, 5]. Therefore, we evaluated the utility of 16S rRNA PCR in the synovial fluid for diagnosing PJI using MSIS criteria.

참고문헌 (10)

  1. Parvizi J, "New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society", Clin Orthop Relat Res, 469, pp.2992~2994 (2011)
  2. Gallo J, "Culture and PCR analysis of joint fluid in the diagnosis of prosthetic joint infection", New Microbiol, 31, pp.97~104 (2008)
  3. Melendez DP, "Evaluation of a genus-and group-specific rapid PCR assay panel on synovial fluid for diagnosis of prosthetic knee infection", J Clin Microbiol, 54, pp.120~126 (2016)
  4. Rak M, "Detection of bacteria with molecular methods in prosthetic joint infection: sonication fluid better than periprosthetic tissue", Acta Orthop, 87, pp.339~345 (2016)
  5. Panousis K, "Poor predictive value of broad-range PCR for the detection of arthroplasty infection in 92 cases", Acta Orthop, 76, pp.341~346 (2005)
  6. Weisburg WG, "16S ribosomal DNA amplification for phylogenetic study", J Bacteriol, 173, pp.697~703 (1991)
  7. Bémer P, "Evaluation of 16S rRNA gene PCR sensitivity and specificity for diagnosis of prosthetic joint infection: a prospective multicenter cross-sectional study", J Clin Microbiol, 52, pp.3583~3589 (2014)
  8. Haag H, "Molecular diagnosis of microbial aetiologies using SepsiTest in the daily routine of a diagnostic laboratory", Diagn Microbiol Infect Dis, 76, pp.413~418 (2013)
  9. Corless CE, "Contamination and sensitivity issues with a real-time universal 16S rRNA PCR", J Clin Microbiol, 38, pp.1747~1752 (2000)
  10. Heininger A, "DNase pretreatment of master mix reagents improves the validity of universal 16S rRNA gene PCR results", J Clin Microbiol, 41, pp.1763~1765 (2003)

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