Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Orthopedic Surgery, Shafa Yahyaiyan Hospital, Iran University of Medical Sciences, Tehran, Iran.
BMC Microbiol. 2021 Apr 13;21(1):112. doi: 10.1186/s12866-021-02164-8.
Accurate and rapid identification of microorganisms causing periprosthetic joint infections (PJIs) are necessary for choosing an appropriate antibiotic therapy. Therefore, molecular techniques are suggested for diagnosis in suspected PJIs. The Broad-range PCR and High-Resolution Melt Analysis (HRMA) were evaluated for the identification of causative organisms of PJIs in this study.
For 47 of 63 specimens, both the culture and broad-range PCR were positive. The culture was found to be able of organism's detection in 74.6% (47/63) of patients. Of 47 positive cultures, 11 (23.4%) were polymicrobial and 36 (76.59%) were monomicrobial cultures, in which 34 (91.89%) cases were detected by HRM assay. The sensitivity, specificity of HRMA vs monomicrobial culture were 91.89, 93.75%, respectively. The sensitivity, specificity of total HRMA (mono + poly) vs culture were 82.92, 93.75%.
HRM assay coupled with broad-range PCR are effective screening, rapid, and relatively cost-effective methods for discrimination of PJIs especially in aiding culture method. Using computer programs such as the Matlab-2018b program for HRM data analysis is also valuable and helpful in diagnosis.
准确快速地鉴定引起人工关节感染（PJI）的微生物对于选择合适的抗生素治疗至关重要。因此，建议在疑似 PJI 中使用分子技术进行诊断。本研究评估了广谱 PCR 和高分辨率熔解分析（HRMA）在鉴定 PJI 致病微生物中的作用。
在 63 个标本中，有 47 个标本的培养和广谱 PCR 均为阳性。培养物在 74.6%（47/63）的患者中能够检测到病原体。在 47 个阳性培养物中，11 个（23.4%）为混合感染，36 个（76.59%）为单一感染，其中 34 个（91.89%）通过 HRM 检测到。HRMA 与单一培养物相比，其敏感性、特异性分别为 91.89%、93.75%。总 HRMA（单 + 多）与培养物相比，其敏感性、特异性分别为 82.92%、93.75%。
HRMA 联合广谱 PCR 是一种有效的筛选方法，具有快速、相对经济有效的特点，尤其有助于培养方法。使用 Matlab-2018b 等计算机程序进行 HRM 数据分析也是有价值且有助于诊断的。
