Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections

Abstract The diagnosis and treatment of periprosthetic joint infection (PJI) currently relies on cultures, which are time-consuming and often fail. Multiplex PCR assays promise reliable and prompt results, but have been heterogeneously evaluated. In this study, we analyse multiplex PCR in pathogen i...

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Autores principales:	Igor Lazic, Susanne Feihl, Peter M. Prodinger, Ingo J. Banke, Andrej Trampuz, Rüdiger von Eisenhart-Rothe, Christian Suren
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4c10196202ee419da262252b3f13c2d0
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spelling	oai:doaj.org-article:4c10196202ee419da262252b3f13c2d02021-12-02T17:37:12ZDiagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections10.1038/s41598-021-99076-42045-2322https://doaj.org/article/4c10196202ee419da262252b3f13c2d02021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99076-4https://doaj.org/toc/2045-2322Abstract The diagnosis and treatment of periprosthetic joint infection (PJI) currently relies on cultures, which are time-consuming and often fail. Multiplex PCR assays promise reliable and prompt results, but have been heterogeneously evaluated. In this study, we analyse multiplex PCR in pathogen identification using only tissue biopsies. 42 patients after revision arthroplasty of the hip or knee were evaluated using multiplex PCR to identify microorganisms. The patients were classified according to the diagnostic criteria published by Zimmerli et al. and the results were compared to the respective microbiological cultures. PJI was detected in 15 patients and 27 revisions were aseptic. The multiplex PCR of tissue biopsies had a sensitivity of 0.3 (95% CI 0.12–0.62), a specificity of 1.0 (0.87–1.0), a positive predictive value of 1.0 (0.48–1.0) and a negative predictive value of 0.73 (0.56–0.86). The diagnostic accuracy of multiplex PCR on tissue biopsy samples is low in comparison to routine microbiological cultures. The evaluation of tissue biopsies using multiplex PCR was prone to false negative results. However, multiplex PCR assays have the advantage of rapid pathogen identification. We therefore recommend further investigation of multiplex PCR in the setting of suspected PJI with a careful choice of specimens.Igor LazicSusanne FeihlPeter M. ProdingerIngo J. BankeAndrej TrampuzRüdiger von Eisenhart-RotheChristian SurenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Igor Lazic Susanne Feihl Peter M. Prodinger Ingo J. Banke Andrej Trampuz Rüdiger von Eisenhart-Rothe Christian Suren Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections
description	Abstract The diagnosis and treatment of periprosthetic joint infection (PJI) currently relies on cultures, which are time-consuming and often fail. Multiplex PCR assays promise reliable and prompt results, but have been heterogeneously evaluated. In this study, we analyse multiplex PCR in pathogen identification using only tissue biopsies. 42 patients after revision arthroplasty of the hip or knee were evaluated using multiplex PCR to identify microorganisms. The patients were classified according to the diagnostic criteria published by Zimmerli et al. and the results were compared to the respective microbiological cultures. PJI was detected in 15 patients and 27 revisions were aseptic. The multiplex PCR of tissue biopsies had a sensitivity of 0.3 (95% CI 0.12–0.62), a specificity of 1.0 (0.87–1.0), a positive predictive value of 1.0 (0.48–1.0) and a negative predictive value of 0.73 (0.56–0.86). The diagnostic accuracy of multiplex PCR on tissue biopsy samples is low in comparison to routine microbiological cultures. The evaluation of tissue biopsies using multiplex PCR was prone to false negative results. However, multiplex PCR assays have the advantage of rapid pathogen identification. We therefore recommend further investigation of multiplex PCR in the setting of suspected PJI with a careful choice of specimens.
format	article
author	Igor Lazic Susanne Feihl Peter M. Prodinger Ingo J. Banke Andrej Trampuz Rüdiger von Eisenhart-Rothe Christian Suren
author_facet	Igor Lazic Susanne Feihl Peter M. Prodinger Ingo J. Banke Andrej Trampuz Rüdiger von Eisenhart-Rothe Christian Suren
author_sort	Igor Lazic
title	Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections
title_short	Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections
title_full	Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections
title_fullStr	Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections
title_full_unstemmed	Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections
title_sort	diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4c10196202ee419da262252b3f13c2d0
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Diagnostic accuracy of multiplex polymerase chain reaction on tissue biopsies in periprosthetic joint infections

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