Archive for February 14, 2017

Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America

Clin Infect Dis. 2013 Jan;56(1):e1-e25.

Osmon DR1, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR; Infectious Diseases Society of America.

Author information

1Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. osmon.douglas@mayo.edu

Abstract

These guidelines are intended for use by infectious disease specialists, orthopedists, and other healthcare professionals who care for patients with prosthetic joint infection (PJI). They include evidence-based and opinion-based recommendations for the diagnosis and management of patients with PJI treated with debridement and retention of the prosthesis, resection arthroplasty with or without subsequent staged reimplantation, 1-stage reimplantation, and amputation.

PDF

http://cid.oxfordjournals.org/content/56/1/e1.full.pdf

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February 14, 2017 at 8:09 am

Evaluation of 16S rRNA gene PCR sensitivity and specificity for diagnosis of prosthetic joint infection: a prospective multicenter cross-sectional study.

J Clin Microbiol. 2014 Oct;52(10):3583-9.

Bémer P1, Plouzeau C2, Tande D3, Léger J4, Giraudeau B4, Valentin AS5, Jolivet-Gougeon A6, Vincent P6, Corvec S7, Gibaud S7, Juvin ME7, Héry-Arnaud G3, Lemarié C8, Kempf M8, Bret L9, Quentin R5, Coffre C4, de Pinieux G10, Bernard L11, Burucoa C2; Centre de Référence des Infections Ostéo-articulaires du Grand Ouest (CRIOGO) Study Team.

Collaborators (32)

Author information

1CHU Nantes, Laboratoire de Bactériologie, Nantes, France pascale.bemer@chu-nantes.fr.

2CHU Poitiers, Laboratoire de Bactériologie, Poitiers, France.

3CHU Brest, Laboratoire de Bactériologie, Brest, France.

4INSERM, CIC 1415, Tours, France.

5CHU Tours, Laboratoire de Bactériologie, Tours, France.

6CHU Rennes, Laboratoire de Bactériologie, Rennes, France.

7CHU Nantes, Laboratoire de Bactériologie, Nantes, France.

8CHU Angers, Angers, France.

9CHU Orléans, Laboratoire de Bactériologie, Orléans, France.

10CHU Tours, Laboratoire d’Anatomo-Pathologie, Tours, France.

11CHU Tours, Service des Maladies Infectieuses, Tours, France.

Abstract

There is no standard method for the diagnosis of prosthetic joint infection (PJI). The contribution of 16S rRNA gene PCR sequencing on a routine basis remains to be defined. We performed a prospective multicenter study to assess the contributions of 16S rRNA gene assays in PJI diagnosis. Over a 2-year period, all patients suspected to have PJIs and a few uninfected patients undergoing primary arthroplasty (control group) were included. Five perioperative samples per patient were collected for culture and 16S rRNA gene PCR sequencing and one for histological examination. Three multicenter quality control assays were performed with both DNA extracts and crushed samples. The diagnosis of PJI was based on clinical, bacteriological, and histological criteria, according to Infectious Diseases Society of America guidelines. A molecular diagnosis was modeled on the bacteriological criterion (≥ 1 positive sample for strict pathogens and ≥ 2 for commensal skin flora). Molecular data were analyzed according to the diagnosis of PJI. Between December 2010 and March 2012, 264 suspected cases of PJI and 35 control cases were included. PJI was confirmed in 215/264 suspected cases, 192 (89%) with a bacteriological criterion. The PJIs were monomicrobial (163 cases [85%]; staphylococci, n = 108; streptococci, n = 22; Gram-negative bacilli, n = 16; anaerobes, n = 13; others, n = 4) or polymicrobial (29 cases [15%]). The molecular diagnosis was positive in 151/215 confirmed cases of PJI (143 cases with bacteriological PJI documentation and 8 treated cases without bacteriological documentation) and in 2/49 cases without confirmed PJI (sensitivity, 73.3%; specificity, 95.5%). The 16S rRNA gene PCR assay showed a lack of sensitivity in the diagnosis of PJI on a multicenter routine basis.

PDF

http://jcm.asm.org/content/52/10/3583.full.pdf

 

February 14, 2017 at 8:07 am


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