Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNAReportar como inadecuado

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The Scientific World JournalVolume 2013 2013, Article ID 950548, 4 pages

Research Article

Department of Orthopaedic Surgery, Chia-Yi Chang Gung Memorial Hospital, 6 West Sec., Chiapu Road, Putzu City, Chiayi County 613, Taiwan

Department of Orthopaedic Surgery, Linkou Chang Gung Memorial Hospital, Putzu City, Chiayi County 613, Taiwan

College of Medicine, Chang Gung University, Putzu City, Chiayi County 613, Taiwan

Department of Power Mechanical Engineering, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Road, Hsinchu 30013, Taiwan

Institute of NanoEngineering and Microsystems, National Tsing Hua University, Hsinchu 30013, Taiwan

Received 13 August 2013; Accepted 25 September 2013

Academic Editors: D. Sakai and O. Wahlstrom

Copyright © 2013 Mel S. Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.

Autor: Mel S. Lee, Wen-Hsin Chang, Su-Chin Chen, Pang-Hsin Hsieh, Hsin-Nung Shih, Steve W. N. Ueng, and Gwo-Bin Lee



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