Multicentre prospective evaluation of histological and molecular criterion for diagnosis of prosthetic-joint infection - Archive ouverte HAL Access content directly
Conference Poster Year : 2013

Multicentre prospective evaluation of histological and molecular criterion for diagnosis of prosthetic-joint infection

(1, 2) , (3) , (4) , (5) , (6, 7) , (8) , (9) , (10, 11) , (10) , (7, 12) , (13) , (14) , (15) , (7) , (16) , (16, 17) , (4, 18)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Julie Léger
  • Function : Author

Abstract

Objectives:

This multicenter prospective study was performed to assess the contribution of broad range PCR diagnosis in prosthetic-joint infection (PJI).

Methods:

Adult patients treated for PJI at 7 centers were included between December 2010 and March 2012. Six per-operative samples were obtained for each patient, 5 for conventional cultures and 16S rRNA gene real-time PCR followed by sequencing, and 1 for histopathological classification according to Morawietz. Cultures and PCR were performed in a highly standardized manner, with 3 quality controls of PCR analyses. An infection was considered as proved (3 criteria: per-operative, bacteriological and histological), probable (clinical or bacteriological criterium), or excluded (no criterium). Molecular criterium for predicting PJI was determined using the bacteriological one as reference (>=1 positive sample for virulent organism, and >=3 positive samples for coagulase-negative staphylococci (CoNS) and P. acnes).

Results:

299 patients were included, 264 with suspicion of sepsis (S) and 35 as controls (C). The 264 S presented with acute (19%), or chronic suspicion of PJI (81%). Infection was proved or probable in 212/264 S (80%), with the bacteriological criterium in 189/212 S (89%). Out of these, 156 (83%) had monomicrobial and 33 (17%) polymicrobial infections. The isolated pathogens were S. aureus (40%), CoNS (25%), streptococci (14%), Gram-Negative rods (10%), and anaerobes 8%.
Histology results were not available for 55 patients, leaving 244 patients available for analysis. Histological findings of infection (Morawietz types II or III) were present in 128/169 (76%) proved or probable infections, in 3 patients without any other criterium, and were absent in excluded infections (n=42) and controls (n=29). PCR results were not analysable for 32 patients (S=28, C=4), leaving 267 patients (S=236, C=31) available for analysis. Molecular criterium of infection was present in 63/68 (93%) proved infections, 83/124 (67%) probable infections, 3/42 excluded infections, 0/2 histological criterium alone and 2/31 controls. Molecular criterium of infection was absent in 34/189 (18%) culture-positive S, and present in 8/23 culture-negative S (8 patients treated with antibiotics).

Conclusions:

According to this multicenter prospective study, 16S rRNA gene real-time PCR is less susceptible than culture for diagnosis of PJI. Molecular analysis could be recommended in culture-negative patients who were receiving antibiotics.

Not file

Dates and versions

hal-03137535 , version 1 (10-02-2021)

Identifiers

  • HAL Id : hal-03137535 , version 1
  • OKINA : ua11345

Cite

Pascale Bémer, Didier Tande, Chloé Plouzeau, Julie Léger, Anne-Sophie Domelier-Valentin, et al.. Multicentre prospective evaluation of histological and molecular criterion for diagnosis of prosthetic-joint infection. 23rd European Congress of Clinical Microbiology and Infectious Diseases, 2013, Berlin, Germany. 2013. ⟨hal-03137535⟩
66 View
0 Download

Share

Gmail Facebook Twitter LinkedIn More