Multiplex Antibody Detection for Noninvasive Genus-Level Diagnosis of Prosthetic Joint Infection

April 9, 2017 at 7:17 pm

Journal of Clinical Microbiology April 2016 V.54 N.4 P.1065-1073

Simon Marmor, Thomas Bauer, Nicole Desplaces, Beate Heym, Anne-Laure Roux, Olivier Sol, Julie Rogé, Florence Mahé, Laurent Désiré, Philippe Aegerter, Idir Ghout, Jacques Ropers, Jean-Louis Gaillard, and Martin Rottman

aService de Chirurgie Orthopédique, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France

bService de Chirurgie Orthopédique et Traumatologie, Hôpital Ambroise Paré (Assistance Publique–Hôpitaux de Paris [AP-HP]), Boulogne-Billancourt, France

cService de Microbiologie, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France

dLaboratoire de Microbiologie, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France

eUMR 1173, UFR Simone Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France

fDIAXONHIT, Paris, France

gUnité de Recherche Clinique Paris Île-de-France Ouest, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France

hLaboratoire de Microbiologie, Hôpital Raymond Poincaré (AP-HP), Garches, France

We developed and evaluated a multiplex antibody detection-based immunoassay for the diagnosis of prosthetic joint infections (PJIs). Sixteen protein antigens from three Staphylococcus species (Staphylococcus aureus, Staphylococcus epidermidis, and Staphylococcus lugdunensis) (8 antigens), Streptococcus agalactiae (4 antigens), and Propionibacterium acnes (4 antigens) were selected by comparative immunoproteomics using serum samples from PJI cases versus controls. A bead-based multiplex immunoassay that measured serum IgG against purified, recombinant forms of each of the 16 antigens was developed. We conducted a prospective study to evaluate the performance of the assay. A PJI was defined by the presence of a sinus tract and/or positive intraoperative sample cultures (at least one sample yielding a virulent organism or at least two samples yielding the same organism). A total of 455 consecutive patients undergoing revision or resection arthroplasty (hip, 66.3%; knee, 29.7%; shoulder, 4%) at two French reference centers for the management of PJI were included: 176 patients (38.7%) were infected and 279 (61.3%) were not. About 60% of the infections involved at least one of the species targeted by the assay. The sensitivity/specificity values were 72.3%/80.7% for targeted staphylococci, 75%/92.6% for S. agalactiae, and 38.5%/84.8% for P. acnes. The assay was more sensitive for infections occurring >3 months after arthroplasty and for patients with an elevated C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR). However, it detected 64.3% and 58.3% of targeted staphylococcal infections associated with normal CRP and ESR values, respectively. This new multiplex immunoassay approach is a novel noninvasive tool to evaluate patients suspected of having PJIs and provides information complementary to that from inflammatory marker values.

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http://jcm.asm.org/content/54/4/1065.full.pdf

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Entry filed under: Bacterias, Biología Molecular, Epidemiología, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, Infecciones nosocomiales, Infecciones osteo-articulares-musculares, Infecciones relacionadas a prótesis, Metodos diagnosticos, REPORTS, Sepsis.

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