title: Ureaplasma parvum prosthetic joint infection detected by PCR.
abstract: We describe the first reported case of Ureaplasma parvum prosthetic joint infection (PJI) detected by PCR. Ureaplasma species do not possess a cell wall and are usually associated with colonization and infection of mucosal surfaces (not prosthetic material). U. parvum is a relatively new species name for certain serovars of Ureaplasma urealyticum, and PCR is useful for species determination. Our patient presented with late infection of his right total knee arthroplasty. Intraoperative fluid and tissue cultures and pre- and postoperative synovial fluid cultures were all negative. To discern the pathogen, we employed PCR coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). Our patient's failure to respond to empirical antimicrobial treatment and our previous experience with PCR/ESI-MS in culture-negative cases of infection prompted us to use this approach over other diagnostic modalities. PCR/ESI-MS detected U. parvum in all samples. U. parvum-specific PCR testing was performed on all synovial fluid samples to confirm the U. parvum detection.
authors.affiliation: University of Illinois School of Medicine, Department of Medicine, Peoria, Illinois, USA jjf@uic.edu.
authors.forename: John J
authors.initials: JJ
authors.lastname: Farrell
authors.affiliation: Division of Laboratory Medicine, St. Francis Medical Center, Peoria, Illinois, USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Larson
authors.affiliation: University of Illinois School of Medicine, Department of Orthopedic Surgery, Peoria, Illinois, USA.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Akeson
authors.affiliation: Ibis Biosciences, Carlsbad, California, USA.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Lowery
authors.affiliation: Ibis Biosciences, Carlsbad, California, USA.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Rounds
authors.affiliation: Ibis Biosciences, Carlsbad, California, USA.
authors.forename: Rangarajan
authors.initials: R
authors.lastname: Sampath
authors.affiliation: Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Research Service, Cleveland, Ohio, USA Case Western Reserve University, Departments of Medicine, Pharmacology and Molecular Microbiology, Cleveland, Ohio, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bonomo
authors.affiliation: Divisions of Clinical Microbiology and Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Patel
mesh_terms: D000368:Aged; D001168:Arthritis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D006801:Humans; D008297:Male; D025202:Molecular Diagnostic Techniques; D016133:Polymerase Chain Reaction; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D021241:Spectrometry, Mass, Electrospray Ionization; D013582:Synovial Fluid / Q000382:microbiology; D014481:United States; D014509:Ureaplasma / Q000302:isolation & purification*; D016869:Ureaplasma Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology