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Polymerasekettenreaktion-gestützte Erregerdiagnostik in der Rheumatologie

PCR-based detection of pathogens in clinical rheumatology

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Zusammenfassung

In der Differenzialdiagnostik müssen Rheumatologen häufig neben autoimmunbedingten Erkrankungen auch Infektionen (z. B. eine Lyme-Arthritis) oder reaktive Krankheitsbilder (z. B. eine reaktive Arthritis nach einem urogenitalen bakteriellen Infekt) in Erwägung ziehen. Des Weiteren können Infektionen mit atypischer Präsentation oder mit atypischen Erregern (opportunistische Infektionen) unter der immunsuppressiven Therapie von rheumatischen Erkrankungen auftreten. In der mikrobiologischen Diagnostik kommen hierfür nicht nur konventionelle Kulturverfahren, sondern zunehmend auch PCR (Polymerasekettenreaktion)-basierte Verfahren zum direkten Nachweis von Erregern zum Einsatz. Ziel dieser Übersicht ist es, in der Rheumatologie häufig eingesetzte PCR-Verfahren vorzustellen und ihre Vorteile bzw. Grenzen im Vergleich zu kulturellen Nachweisverfahren aufzuzeigen.

Abstract

In the differential diagnostics of autoimmune-mediated rheumatic diseases, rheumatologists often have to consider infections (e. g. Lyme arthritis) or reactive diseases (e. g. reactive arthritis after urogenital bacterial infections). Furthermore, infections with an atypical presentation or caused by atypical pathogens (opportunistic infections) can complicate the immunosuppressive therapy of autoimmune diseases. For this purpose not only conventional microbiological culture methods but also PCR-based methods are increasingly being applied for the direct detection of pathogens in clinical specimens. The aim of this overview is to present commonly used PCR methods in the clinical practice of rheumatology and to describe their benefits and limitations compared to culture-based detection methods.

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Authors and Affiliations

  1. Klinik und Poliklinik für Rheumatologie/Klinische Immunologie, Asklepios Klinikum Bad Abbach, 93077, Bad Abbach, Deutschland

    B. Ehrenstein

  2. Institut für Klinische Mikrobiologie und Hygiene, Universitätsklinikum Regensburg (UKR), 93053, Regensburg, Deutschland

    U. Reischl

Authors
  1. B. Ehrenstein
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Correspondence to B. Ehrenstein.

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Interessenkonflikt

B. Ehrenstein und U. Reischl geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Redaktion

M. Fleck, Bad Abbach

T. Dörner, Berlin

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Ehrenstein, B., Reischl, U. Polymerasekettenreaktion-gestützte Erregerdiagnostik in der Rheumatologie. Z Rheumatol 75, 381–388 (2016). https://doi.org/10.1007/s00393-016-0058-6

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  • DOI: https://doi.org/10.1007/s00393-016-0058-6

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