PCR diagnostic system in the treatment of prosthetic joint infections
In our prospective study, we examined whether a multiplex PCR diagnostic method is suitable for the primary detection of pathogens. We also examined the possibility and sensitivity of detecting genes responsible for biofilm production and methicillin resistance. From 2007 to 2009, 94 patients were included in the study. A UNB (universal detection of 16S ribosomal bacterial DNA) and UNF (universal detection of pathogenic fungi) were used in the primary detection. A multiplex assay for biofilm production, methicillin resistance allowed us to distinguish between Gram positivity and negativity and to detect Staphylococci. From all the samples, the culture was positive in 53.2 % of cases, and by using the UNB method, we detected bacteria in 79.8 % of cases—the UNF detection of fungi was positive in 10.6 % of cases. In 75 % of positive findings, we detected a Gram-negative bacterium in 65.3 % of cases. In 47.2 % of Staphylococci detected, the ability to produce biofilm was confirmed. 61.1 % of the Staphylococci exhibited a methicillin resistance. Our multiplex scheme cannot yet fully replace microbial cultivation but can be a rational guide when choosing an appropriate antibiotic therapy in cases where the microbial culture is negative.
KeywordsMicrobial Culture Prosthetic Joint Infection Methicillin Resistance Multiplex Detection Universal Detection
Universal Bacterial Detection of 16S ribosomal DNA
Universal Fungal Detection by non-transcribed regions ITS1 and ITS2 between genes for 18S rDNA and 28 s rDNA
Methicillin-resistant Staphylococcus aureus
Methicillin-sensitive Staphylococcus aureus
Restriction fragment length polymorphism
This study was supported by project for conceptual development of research organization 00064203 (Ministry of Health, Czech Republic), Research program of Charles University P25/LF1/2, Grant IGA MZ ČR 14218–2.
Conflict of interest
The authors declare that they have no conflict of interest.
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