title: [Bacterial pathogens of periprosthetic infections and diagnostic possibilities].
abstract: BACKGROUND
  Successful treatment of patients with periprosthetic infection (PPI) requires a correct diagnosis supported by clinical, imaging, microbiological and other laboratory evidence. Equally important is to determine the causative agent of the infection as this may affect the subsequent treatment strategy. The paper aims at presenting cultivation results in a group of PPI patients and their comparison with molecular biology methods.
  
  
  METHODS
  Material obtained during operations of PPI patients was examined by both the standard culture methods and the PCR technique to identify the etiological agents. The results were statistically compared.
  
  
  RESULTS
  In total, the group comprised 49 patients with hip, knee or elbow replacement infection verified during the operation. In 42 cases (85.7 %), the infectious agent was identified by cultivation. The infection was most frequently (62.0 %) caused by coagulase-negative staphylococci and Staphylococcus aureus. Monomicrobial and polymicrobial infections were demonstrated in 35 (71.4 %) and 7 (14.3 %) patients, respectively. The PCR assay aimed at the 16S rRNA segment of bacterial DNA was performed in 35 patients, with positive results in 25 cases (71.4 %). In 82.6 %, the agents detected by specific PCR were consistent with the cultivation results. A statistically non-significant difference in sensitivity between the two methods was found, with higher specificity in the case of PCR.
  
  
  CONCLUSIONS
  Standard cultivation methods remain a highly successful and useful tool for identifying the PPI causative agents.
authors.affiliation: Department of Orthopaedic, Faculty Hospital of Olomouc, Czech Republic.
authors.forename: Jirí
authors.initials: J
authors.lastname: Gallo
authors.forename: Milan
authors.initials: M
authors.lastname: Kolár
authors.forename: Dagmar
authors.initials: D
authors.lastname: Koukalová
authors.forename: Pavel
authors.initials: P
authors.lastname: Sauer
authors.forename: Yvona
authors.initials: Y
authors.lastname: Lovecková
authors.forename: Milos
authors.initials: M
authors.lastname: Dendis
authors.forename: Michaela
authors.initials: M
authors.lastname: Kesselová
authors.forename: Jana
authors.initials: J
authors.lastname: Petrzelová
authors.forename: Jana
authors.initials: J
authors.lastname: Yapletalová
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis / Q000382:microbiology*; D001431:Bacteriological Techniques; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology*; D012680:Sensitivity and Specificity
chemical_list: D004269:DNA, Bacterial