Document Detail


The role of molecular diagnostics in implant-associated bone and joint infection.
MedLine Citation:
PMID:  23148447     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Clin Microbiol Infect 2012; 18: 1168-1175 ABSTRACT: Microbiological culture is the conventional method for establishing the diagnosis in implant-associated bone and joint infection, but it may lack both specificity and sensitivity. Molecular diagnosis has been an important step in the diagnosis of infectious diseases. We review the principles and the role of molecular diagnosis in improving the aetiological diagnosis of implant-associated bone and joint infection. Currently, molecular diagnosis mainly includes conventional broad-range PCR and specific PCR assays. These tools are efficient, but several pitfalls exist that necessitate rigour in all steps of the process. In implant-associated bone and joint infection, molecular assays have been shown to be useful in complementing culture techniques to identify microorganisms when patients have previously received antibiotics or in the presence of fastidious microorganisms. Broad-range PCR targeting the 16S rRNA sequence followed by sequencing must be performed in culture-negative specimens when infection is suspected on the basis of clinical signs and symptoms or inflammatory syndrome. This molecular tool has allowed not only increasing identification of anaerobic bacteria, such as Finegoldia magna, but also the discovery of the role of Tropheryma whipplei, an aetiological agent of implant-associated bone and joint infection in patients without Whipple's disease. Real-time pathogen-specific PCR assays performed in a closed system are more sensitive and specific than broad-range PCR, but each assay is typically able to detect only a single microorganism. These assays should be performed to confirm the identification provided by broad-spectrum PCR, and also when broad-range PCR fails to detect a microorganism despite efficient DNA extraction.
Authors:
P-Y Lévy; F Fenollar
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases     Volume:  18     ISSN:  1469-0691     ISO Abbreviation:  Clin. Microbiol. Infect.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9516420     Medline TA:  Clin Microbiol Infect     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1168-1175     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.
Affiliation:
 Université d'Aix-Marseille, Unité des rickettsies, URMITE CNRS-IRD, Faculté de médecine  Pôle de Maladies Infectieuses, Marseille, France.
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