Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA

The diagnosis of periprosthetic joint infection is sometimes straightforward with purulent discharge from the fistula tract communicating to the joint prosthesis. However it is often difficult to differentiate septic from aseptic loosening of prosthesis because of the high culture-negative rates in...

Full description

Saved in:
Bibliographic Details
Main Authors: Mel S. Lee, Wen-Hsin Chang, Su-Chin Chen, Pang-Hsin Hsieh, Hsin-Nung Shih, Steve W. N. Ueng, Gwo-Bin Lee
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2013/950548
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832561166191165440
author Mel S. Lee
Wen-Hsin Chang
Su-Chin Chen
Pang-Hsin Hsieh
Hsin-Nung Shih
Steve W. N. Ueng
Gwo-Bin Lee
author_facet Mel S. Lee
Wen-Hsin Chang
Su-Chin Chen
Pang-Hsin Hsieh
Hsin-Nung Shih
Steve W. N. Ueng
Gwo-Bin Lee
author_sort Mel S. Lee
collection DOAJ
description The diagnosis of periprosthetic joint infection is sometimes straightforward with purulent discharge from the fistula tract communicating to the joint prosthesis. However it is often difficult to differentiate septic from aseptic loosening of prosthesis because of the high culture-negative rates in conventional microbiologic culture. This study used quantitative reverse transcription polymerase chain reaction (RT-qPCR) to amplify bacterial 16S ribosomal RNA in vitro and in 11 clinical samples. The in vitro analysis demonstrated that the RT-qPCR method was highly sensitive with the detection limit of bacterial 16S rRNA being 0.148 pg/μl. Clinical specimens were analyzed using the same protocol. The RT-qPCR was positive for bacterial detection in 8 culture-positive cases (including aerobic, anaerobic, and mycobacteria) and 2 culture-negative cases. It was negative in one case that the final diagnosis was confirmed without infection. The molecular diagnosis of bacterial infection using RT-qPCR to detect bacterial 16S rRNA around a prosthesis correlated well with the clinical findings. Based on the promising clinical results, we were attempting to differentiate bacterial species or drug-resistant strains by using species-specific primers and to detect the persistence of bacteria during the interim period before the second stage reimplantation in a larger scale of clinical subjects.
format Article
id doaj-art-a608354f70f54267b140ef0f9834668f
institution Kabale University
issn 1537-744X
language English
publishDate 2013-01-01
publisher Wiley
record_format Article
series The Scientific World Journal
spelling doaj-art-a608354f70f54267b140ef0f9834668f2025-02-03T01:25:50ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/950548950548Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNAMel S. Lee0Wen-Hsin Chang1Su-Chin Chen2Pang-Hsin Hsieh3Hsin-Nung Shih4Steve W. N. Ueng5Gwo-Bin Lee6Department of Orthopaedic Surgery, Chia-Yi Chang Gung Memorial Hospital, 6 West Sec., Chiapu Road, Putzu City, Chiayi County 613, TaiwanDepartment of Power Mechanical Engineering, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Road, Hsinchu 30013, TaiwanDepartment of Orthopaedic Surgery, Linkou Chang Gung Memorial Hospital, Putzu City, Chiayi County 613, TaiwanDepartment of Orthopaedic Surgery, Linkou Chang Gung Memorial Hospital, Putzu City, Chiayi County 613, TaiwanDepartment of Orthopaedic Surgery, Linkou Chang Gung Memorial Hospital, Putzu City, Chiayi County 613, TaiwanDepartment of Orthopaedic Surgery, Linkou Chang Gung Memorial Hospital, Putzu City, Chiayi County 613, TaiwanDepartment of Power Mechanical Engineering, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Road, Hsinchu 30013, TaiwanThe diagnosis of periprosthetic joint infection is sometimes straightforward with purulent discharge from the fistula tract communicating to the joint prosthesis. However it is often difficult to differentiate septic from aseptic loosening of prosthesis because of the high culture-negative rates in conventional microbiologic culture. This study used quantitative reverse transcription polymerase chain reaction (RT-qPCR) to amplify bacterial 16S ribosomal RNA in vitro and in 11 clinical samples. The in vitro analysis demonstrated that the RT-qPCR method was highly sensitive with the detection limit of bacterial 16S rRNA being 0.148 pg/μl. Clinical specimens were analyzed using the same protocol. The RT-qPCR was positive for bacterial detection in 8 culture-positive cases (including aerobic, anaerobic, and mycobacteria) and 2 culture-negative cases. It was negative in one case that the final diagnosis was confirmed without infection. The molecular diagnosis of bacterial infection using RT-qPCR to detect bacterial 16S rRNA around a prosthesis correlated well with the clinical findings. Based on the promising clinical results, we were attempting to differentiate bacterial species or drug-resistant strains by using species-specific primers and to detect the persistence of bacteria during the interim period before the second stage reimplantation in a larger scale of clinical subjects.http://dx.doi.org/10.1155/2013/950548
spellingShingle Mel S. Lee
Wen-Hsin Chang
Su-Chin Chen
Pang-Hsin Hsieh
Hsin-Nung Shih
Steve W. N. Ueng
Gwo-Bin Lee
Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA
The Scientific World Journal
title Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA
title_full Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA
title_fullStr Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA
title_full_unstemmed Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA
title_short Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA
title_sort molecular diagnosis of periprosthetic joint infection by quantitative rt pcr of bacterial 16s ribosomal rna
url http://dx.doi.org/10.1155/2013/950548
work_keys_str_mv AT melslee moleculardiagnosisofperiprostheticjointinfectionbyquantitativertpcrofbacterial16sribosomalrna
AT wenhsinchang moleculardiagnosisofperiprostheticjointinfectionbyquantitativertpcrofbacterial16sribosomalrna
AT suchinchen moleculardiagnosisofperiprostheticjointinfectionbyquantitativertpcrofbacterial16sribosomalrna
AT panghsinhsieh moleculardiagnosisofperiprostheticjointinfectionbyquantitativertpcrofbacterial16sribosomalrna
AT hsinnungshih moleculardiagnosisofperiprostheticjointinfectionbyquantitativertpcrofbacterial16sribosomalrna
AT stevewnueng moleculardiagnosisofperiprostheticjointinfectionbyquantitativertpcrofbacterial16sribosomalrna
AT gwobinlee moleculardiagnosisofperiprostheticjointinfectionbyquantitativertpcrofbacterial16sribosomalrna