title: Low sensitivity of periprosthetic tissue PCR for prosthetic knee infection diagnosis.
abstract: We previously described a rapid PCR panel targeting bacteria associated with prosthetic joint infection (PJI) for use on biofilms dislodged from explanted hip and knee arthroplasties. Herein, we tested the PCR panel on periprosthetic tissues from 95 subjects undergoing resection knee arthroplasty, all of whom had had tissue cultures performed. A subset also had synovial fluid culture (n=89) and/or device vortexing and sonication with culture (n=58), and a subset of these PCR (n=36) of resulting sonicate fluid, performed. Of the 64 subjects with PJI, 10 and 44 had positive tissue PCR and cultures, respectively, one of whom had a positive tissue PCR with negative tissue cultures. The overall sensitivity of tissue PCR (16%) was much lower than that of tissue (69%), synovial fluid (72%) and sonicate fluid (77%) culture as well as sonicate fluid PCR (78%) (P < 0.00001, P < 0.00001, P < 0.00001, and P=0.0003, respectively). Periprosthetic tissue PCR, as performed herein, has poor sensitivity for PJI diagnosis.
authors: Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
authors: Seong Yeol
authors: SY
authors: Ryu
authors: Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
authors: Kerryl E
authors: KE
authors: Greenwood-Quaintance
authors: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors: Arlen D
authors: AD
authors: Hanssen
authors: Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, MN 55905, USA.
authors: Jayawant N
authors: JN
authors: Mandrekar
authors: Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA. Electronic address: patel.robin@mayo.edu.
authors: Robin
authors: R
authors: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000235:genetics*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology*; D001431:Bacteriological Techniques; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D016133:Polymerase Chain Reaction / Q000379:methods; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013582:Synovial Fluid / Q000382:microbiology
keywords: PCR; Prosthetic joint infection