title: Multiplex Antibody Detection for Noninvasive Genus-Level Diagnosis of Prosthetic Joint Infection.
abstract: We developed and evaluated a multiplex antibody detection-based immunoassay for the diagnosis of prosthetic joint infections (PJIs). Sixteen protein antigens from three Staphylococcusspecies (Staphylococcus aureus,Staphylococcus epidermidis, and Staphylococcus lugdunensis) (8 antigens),Streptococcus agalactiae(4 antigens), and Propionibacterium acnes(4 antigens) were selected by comparative immune proteomics using serum samples from PJI cases versus controls. A bead-based multiplex immunoassay that measured serum IgG against purified, recombinant forms of each of the 16 antigens was developed. We conducted a prospective study to evaluate the performance of the assay. A PJI was defined by the presence of a sinus tract and/or positive intraoperative sample cultures (at least one sample yielding a virulent organism or at least two samples yielding the same organism). A total of 455 consecutive patients undergoing revision or resection arthroplasty (hip, 66.3%; knee, 29.7%; shoulder, 4%) at two French reference centers for the management of PJI were included: 176 patients (38.7%) were infected and 279 (61.3%) were not. About 60% of the infections involved at least one of the species targeted by the assay. The sensitivity/specificity values were 72.3%/80.7% for targeted staphylococci, 75%/92.6% forS. agalactiae, and 38.5%/84.8% forP. acnes The assay was more sensitive for infections occurring >3 months after arthroplasty and for patients with an elevated C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR). However, it detected 64.3% and 58.3% of targeted staphylococcal infections associated with normal CRP and ESR values, respectively. This new multiplex immunoassay approach is a novel noninvasive tool to evaluate patients suspected of having PJIs and provides information complementary to that from inflammatory marker values.
authors: Service de Chirurgie Orthopédique, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France.
authors: Simon
authors: S
authors: Marmor
authors: Service de Chirurgie Orthopédique et Traumatologie, Hôpital Ambroise Paré (Assistance Publique-Hôpitaux de Paris [AP-HP]), Boulogne-Billancourt, France.
authors: Thomas
authors: T
authors: Bauer
authors: Service de Microbiologie, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France.
authors: Nicole
authors: N
authors: Desplaces
authors: Laboratoire de Microbiologie, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France UMR 1173, UFR Simone Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.
authors: Beate
authors: B
authors: Heym
authors: Laboratoire de Microbiologie, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France UMR 1173, UFR Simone Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.
authors: Anne-Laure
authors: AL
authors: Roux
authors: DIAXONHIT, Paris, France.
authors: Olivier
authors: O
authors: Sol
authors: DIAXONHIT, Paris, France.
authors: Julie
authors: J
authors: Rogé
authors: DIAXONHIT, Paris, France.
authors: Florence
authors: F
authors: Mahé
authors: DIAXONHIT, Paris, France.
authors: Laurent
authors: L
authors: Désiré
authors: Unité de Recherche Clinique Paris Île-de-France Ouest, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France.
authors: Philippe
authors: P
authors: Aegerter
authors: Unité de Recherche Clinique Paris Île-de-France Ouest, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France.
authors: Idir
authors: I
authors: Ghout
authors: Unité de Recherche Clinique Paris Île-de-France Ouest, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France.
authors: Jacques
authors: J
authors: Ropers
authors: Laboratoire de Microbiologie, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France UMR 1173, UFR Simone Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.
authors: Jean-Louis
authors: JL
authors: Gaillard
authors: UMR 1173, UFR Simone Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France Laboratoire de Microbiologie, Hôpital Raymond Poincaré (AP-HP), Garches, France martin.rottman@aphp.fr.
authors: Martin
authors: http://orcid.org/0000-0001-5953-3344
authors: M
authors: Rottman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology; D001170:Arthritis, Infectious / Q000175:diagnosis*; D001424:Bacterial Infections / Q000175:diagnosis*; D005260:Female; D005602:France; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000175:diagnosis*; D011994:Recombinant Proteins / Q000276:immunology; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods*
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D007074:Immunoglobulin G; D011994:Recombinant Proteins