Direct detection of pathogens in osteoarticular infections by polymerase chain reaction amplification and microarray hybridization.
BACKGROUND
Molecular biological techniques such as the polymerase chain reaction (PCR) and DNA microarray are used for the detection/identification of microorganisms; however, few reports have discussed the clinical utility of microarray analysis for identification of causative organisms of osteoarticular infections. It is important to examine the utility of PCR amplification followed by analysis of DNA microarray carrying specific oligonucleotides.


METHODS
This study included 101 biological samples obtained from 96 patients who underwent conservative and/or surgical treatment for osteoarticular infections. In this double-blind comparative study, routine conventional testing and the research groups were unaware of each other's interpretation until identical specimens were identified by culture and microarray analysis.


RESULTS
Results of PCR microarray analysis were positive for 25 samples and negative for the remaining 76 samples within 24 h, and the results of the cultures (available after a mean of 3.54 days) were positive in 26 samples and negative for the remaining 75 samples. The sensitivity of microarray analysis was 84.6% (22/26) and specificity was 88.0% (22/25). Discrepant results were identified in seven samples, including a negative culture and a positive microarray in three cases and a positive culture and a negative microarray in four other cases.


CONCLUSIONS
The PCR microarray analysis is complementary to routine cultures in identifying causative microorganisms and should be used in patients with highly suspected infections and negative bacterial culture and in patients who require prompt diagnosis and early initiation of antibiotic therapy.
Department of Orthopaedics and Rehabilitation Medicine, Fukui University Faculty of Medical Sciences, Eiheiji, Fukui, Japan.
Kenzo
K
Uchida
Takafumi
T
Yayama
Yasuo
Y
Kokubo
Tsuyoshi
T
Miyazaki
Hideaki
H
Nakajima
Kohei
K
Negoro
Kenichi
K
Takeno
Elisa S
ES
Mwaka
Norbert T
NT
Orwotho
Mitsunobu
M
Shimadzu
Shigeru
S
Kobayashi
Hisatoshi
H
Baba
D001850:Bone Diseases, Infectious / Q000382:microbiology*; D015342:DNA Probes; D004311:Double-Blind Method; D006801:Humans; D020411:Oligonucleotide Array Sequence Analysis; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity
D015342:DNA Probes