Evaluation of rapid mecA gene detection versus standard culture in staphylococcal chronic prosthetic joint infections.
In case of periprosthetic joint infections, the antibiotic treatment administered intraoperatively entails consequences on bacterial ecology with potential secondary effects. This study evaluates the rapid detection of methicillin-resistant staphylococci (MRS) by Xpert® technology directly on intraoperative samples. Xpert® technology was compared to conventional culture for 104 clinical specimens performed on 30 patients. The performance of the test expressed in terms of sensitivity, specificity, positive predictive value, and negative predictive value was, respectively, 87.1%, 100%, 100%, and 94.5% for the 104 specimens, and 92.3%, 100%, 100%, and 94.4% for the 30 patients. With the rapid detection of MRS, the use of vancomycin was limited for 17 of these 30 patients. In conclusion, this technique would allow the implementation of first-line antibiotic treatment adapted to the presence of MRS or not within approximately 1 h and would strongly reduce the use of broad-spectrum antibiotics.
Institute of Microbiology, University Hospital Center, Lille, France.
Marie
M
Titécat
Caroline
C
Loïez
Eric
E
Senneville
Frédéric
F
Wallet
Hervé
H
Dezèque
Laurence
L
Legout
Henri
H
Migaud
René J
RJ
Courcol
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics*; D001431:Bacteriological Techniques / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D010003:Osteoarthritis / Q000175:diagnosis / Q000382:microbiology*; D046915:Penicillin-Binding Proteins; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology*; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology*; D013997:Time Factors; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D046915:Penicillin-Binding Proteins; C487789:mecA protein, Staphylococcus aureus; D014640:Vancomycin