Naslov
Molecular microbiology diagnostic approaches in periprosthetic joint infections

Autori
Janeš, Andrea ; Mađarević, Tomislav

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, neobjavljeni rad, stručni

Skup
South East European Forum on Orthopaedics and Traumatology

Mjesto i datum
Dubrovnik, Hrvatska, 04.05.2023. - 06.05.2023

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Podatak o recenziji nije dostupan

Ključne riječi
multiplex polymerase chain reaction (PCR) ; 16S rDNA sequencing ; metagenomic sequencing ; matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF)

Sažetak
Aim: Periprosthetic joint infections (PJI) emerged as the most complex infections in orthopedic surgery in developed countries to diagnose and treat. Although sonication of explanted prostheses significantly improved microbiological diagnostics of PJI, using conventional cultures is laborious and time- intensive. Therefore, we aim to present the current developments in new diagnostic methods of PJI and how they compare with conventional cultures of synovial fluid, periprosthetic tissue samples, and sonication fluid. Special emphasis is going to be placed on molecular techniques such as multiplex polymerase chain reaction (PCR), 16S rDNA sequencing, metagenomic sequencing, matrix- assisted laser desorption/ionization time-of- flight (MALDI-TOF), and technology that combines MALDI-TOF and PCR, as they are utilized to detect pathogens most likely responsible for the development of PJI. Of other nonculture-based methods, we shall briefly cover fluorescent in situ hybridization (FISH), microarrays and microcalorimetry. Methods: A literature search was conducted in the Web of Science (WoS) database using relevant keywords: („prosthetic joint infection“ OR „pji“) AND „molecular diagnostic*“. Results: The search returned 27 results, of which 7 were excluded due to the subject unrelated to the object of this review. The rest of the articles were thoroughly read and used to write the review. Conclusion: Although molecular diagnostic methods such as multiplex PCR and genomic and metagenomic sequencing seem very promising for diagnosing PJI, implementing them in PJI microbiological protocols will not single- handedly solve all the challenges clinicians, and clinical microbiologists currently face. These methods are presently used only to complement the results of conventional cultures and should be interpreted in the context of other laboratory, histopathology, and clinical findings. In the foreseeable future, the diagnosis of PJI and the decision on the best course of action in specific clinical cases are going to remain a joint effort of multidisciplinary teams.

Izvorni jezik
Engleski

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