Evidence map›Paper›PMID 25326855›Full record

ArticleInternational orthopaedics2015

Identification of the same species in at least two intra-operative samples for prosthetic joint infection diagnostics yields the best results with broad-range polymerase chain reaction.

Mitja Rak, Darja Barlič-Maganja, Martina Kavčič, Rihard Trebše, Andrej Cőr

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Article in International orthopaedics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
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4citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

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3 · Its place in the literature

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4 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Mitja RakFaculty of Health Sciences, University of Primorska, Polje 42, 6310, Izola, Slovenia, mitja.rak@fvz.upr.si.
Darja Barlič-Maganja
Martina Kavčič
Rihard Trebše
Andrej Cőr

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProsthetic joint infection (PJI) is a devastating complication of total joint arthroplasty. No single laboratory test has perfect sensitivity and specificity; however, culture of periprosthetic tissue is the standard method for PJI diagnosis. Interpretation of positive culture results in PJI diagnostics can be difficult due to the possibility of contamination with microorganisms originating from skin micro flora. Criteria have been established to aid in distinguishing pathogen from contaminant for culture results. A similar criterion has not however been established for polymerase chain reaction (PCR) analysis, which is in part responsible for confusion about the reliability of PCR for PJI diagnostics. The aim of our study was to establish a criterion for interpretation of broad range (BR) PCR results in PJI diagnostics.

methodsSamples of periprosthetic tissue were retrieved from 100 patients with joint prosthesis failure and analysed with BR-PCR. The results of BR-PCR were evaluated based on the number of samples of periprosthetic tissue with the same bacterial species.

resultsThe sensitivity (87.5%) of BR-PCR was highest if the same species was present in at least one sample, although this criterion also resulted in the lowest specificity (92.1%). The sensitivity decreased (83.2%), although without a statistically significant difference, if the same species was present in two or more samples but, at the same time, specificity increased (100%), with a statistically significant difference.

conclusionsFor diagnostics of PJI with BR-PCR the criterion of the same bacterial species in at least two specimens of periprosthetic tissue from the same patient should be used for interpretation of positive results.

Indexed as

AgedAged, 80 and overArthroplastyArthroplasty, ReplacementBacterial InfectionsFemaleHumansIntraoperative PeriodJoint ProsthesisMaleMiddle AgedPolymerase Chain ReactionProspective StudiesProsthesis FailureProsthesis-Related InfectionsReproducibility of Results

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