title: Molecular detection of bacterial DNA in venereal-associated arthritis.
abstract: OBJECTIVE
  To evaluate the utility of polymerase chain reaction (PCR) amplification in detecting DNA from venereal-associated microorganisms in the synovial fluid of patients with inflammatory arthritis.
  
  
  METHODS
  Oligonucleotide primers were developed for nested PCR based on Chlamydia, Ureaplasma, and Neisseria DNA sequences. PCR products were detected by gel electrophoresis and dot-blot hybridization. Primers specific for the target bacterial DNA were used to search for bacterial DNA in 61 synovial fluid specimens from patients with inflammatory arthritis, including several clinically associated with venereal infection.
  
  
  RESULTS
  Five of the 61 synovial fluid specimens were positive for Neisseria gonorrhoeae DNA. Four of the 5 patients had clinical diagnoses of gonococcal arthritis; the other patient had an unexplained monarthritis. One specimen from a patient with a clinical diagnosis of gonococcal arthritis was negative for N gonorrhoeae. Three of the 61 specimens were positive for Chlamydia DNA. Two were derived from patients with clinical diagnoses of reactive arthritis or Reiter's syndrome, and 1 was from a patient with unexplained monarthritis. One of the 61 specimens was positive from Ureaplasma DNA; this sample was from a patient with a clinical diagnosis of Reiter's syndrome. In an additional patient with Reiter's syndrome, Ureaplasma DNA was also found in prostate biopsy tissue and a urine sample obtained after prostate massage (synovial fluid not available).
  
  
  CONCLUSIONS
  These data support the classification of these 3 venereal-associated arthritides as infectious processes, and suggest that PCR for bacterial DNA is a useful method for detecting infectious agents in synovial fluid.
authors.affiliation: University of Pennsylvania Medical Center, Philadelphia 19104, USA.
authors.forename: F
authors.initials: F
authors.lastname: Li
authors.forename: R
authors.initials: R
authors.lastname: Bulbul
authors.forename: H R
authors.initials: HR
authors.lastname: Schumacher
authors.forename: T
authors.initials: T
authors.lastname: Kieber-Emmons
authors.forename: P E
authors.initials: PE
authors.lastname: Callegari
authors.forename: J M
authors.initials: JM
authors.lastname: Von Feldt
authors.forename: D
authors.initials: D
authors.lastname: Norden
authors.forename: B
authors.initials: B
authors.lastname: Freundlich
authors.forename: B
authors.initials: B
authors.lastname: Wang
authors.forename: V
authors.initials: V
authors.lastname: Imonitie
authors.forename: C P
authors.initials: CP
authors.lastname: Chang
authors.forename: I
authors.initials: I
authors.lastname: Nachamkin
authors.forename: D B
authors.initials: DB
authors.lastname: Weiner
authors.forename: W V
authors.initials: WV
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D001170:Arthritis, Infectious / Q000382:microbiology*; D001483:Base Sequence; D002689:Chlamydia / Q000235:genetics* / Q000302:isolation & purification; D017931:DNA Primers; D004269:DNA, Bacterial / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009344:Neisseria gonorrhoeae / Q000235:genetics* / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D013582:Synovial Fluid / Q000382:microbiology; D014509:Ureaplasma / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D017931:DNA Primers; D004269:DNA, Bacterial