Hischebeth Gunnar T R, Randau Thomas M, Buhr Johanna K, Wimmer Matthias D, Hoerauf Achim, Molitor Ernst, Bekeredjian-Ding Isabelle, Gravius Sascha
Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany.
Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany.
J Microbiol Methods. 2016 Feb;121:27-32. doi: 10.1016/j.mimet.2015.12.010. Epub 2015 Dec 13.
Periprosthetic joint infection (PJI) is one of the most challenging complications in orthopedic surgery. In cases of suspected periprosthetic joint infection several diagnostic methods are available. In this study we investigated the performance of the newly available Unyvero i60 implant and tissue infection (ITI) multiplex PCR System. 62 specimens from 31 patients with suspected PJI or aseptic loosening of a painful joint arthoplasty were included in this study. Besides the established diagnostic procedures we included a commercial multiplex PCR detection system for diagnosis of PJI. The PCR results obtained from analysis of sonication and synovial fluids (62 specimens) showed a sensitivity of 66.7%, a specificity of 100%, a positive predictive value (PPV) of 100% and a negative predictive value (NPV) of 68.4% when compared to cultural methods. Notably, cultures from sonication fluid displayed a sensitivity of 88.9%, a specificity of 61.5%, a PPV of 76.2% and a NPV of 80.0% when compared to tissue cultures. In conclusion, multiplex PCR is an additional - rapid - method for diagnosing PJI. Positive results with the PCR assay used in this study were always confirmed by subsequent matching culture positivity. However, apart from the time saved the nucleic acid amplification technique did not yield additional information than that obtained from microbiological cultures.
人工关节周围感染（PJI）是骨科手术中最具挑战性的并发症之一。对于疑似人工关节周围感染的病例，有多种诊断方法可供选择。在本研究中，我们调查了新推出的Unyvero i60植入物和组织感染（ITI）多重PCR系统的性能。本研究纳入了31例疑似人工关节周围感染或疼痛性关节置换术无菌性松动患者的62份标本。除了既定的诊断程序外，我们还纳入了一种用于诊断人工关节周围感染的商业多重PCR检测系统。与培养方法相比，对超声处理液和滑液（62份标本）进行分析获得的PCR结果显示，敏感性为66.7%，特异性为100%，阳性预测值（PPV）为100%，阴性预测值（NPV）为68.4%。值得注意的是，与组织培养相比，超声处理液培养的敏感性为88.9%，特异性为61.5%，PPV为76.2%，NPV为80.0%。总之，多重PCR是诊断人工关节周围感染的一种额外的快速方法。本研究中使用的PCR检测的阳性结果总是通过随后匹配的培养阳性得到证实。然而，除了节省时间外，核酸扩增技术并没有比微生物培养获得更多的信息。
