PCR diagnostic system in the treatment of prosthetic joint infections

• Published in: Folia microbiologica 2015-09, Vol.60 (5), p.385-391
• Main Authors: Jahoda, D, Landor, I, Benedík, J, Pokorný, D, Judl, T, Barták, V, Jahodová, I, Fulín, P, Síbek, M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibiotic resistance; Applied Microbiology; Bacterial Proteins - genetics; biofilm; Biofilms; Biomedical and Life Sciences; diagnostic techniques; DNA; Environmental Engineering/Biotechnology; Female; fungi; genes; Gram-negative bacteria; Gram-Negative Bacteria - genetics; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - microbiology; Humans; Immunology; Joint Prosthesis - microbiology; Life Sciences; Male; methicillin; Microbiology; Middle Aged; Multiplex Polymerase Chain Reaction - methods; Pathogens; patients; polymerase chain reaction; Prospective Studies; prostheses; Prosthesis-Related Infections - diagnosis; Prosthesis-Related Infections - microbiology; Staphylococcal Infections - diagnosis; Staphylococcal Infections - microbiology; Staphylococcus; Staphylococcus - classification; Staphylococcus - genetics; Staphylococcus - isolation & purification; Studies; therapeutics
• ISSN: 0015-5632; 1874-9356
• DOI: 10.1007/s12223-014-0370-y

In our prospective study, we examined whether a multiplex PCR diagnostic method is suitable for the primary detection of pathogens. We also examined the possibility and sensitivity of detecting genes responsible for biofilm production and methicillin resistance. From 2007 to 2009, 94 patients were included in the study. A UNB (universal detection of 16S ribosomal bacterial DNA) and UNF (universal detection of pathogenic fungi) were used in the primary detection. A multiplex assay for biofilm production, methicillin resistance allowed us to distinguish between Gram positivity and negativity and to detect Staphylococci. From all the samples, the culture was positive in 53.2 % of cases, and by using the UNB method, we detected bacteria in 79.8 % of cases—the UNF detection of fungi was positive in 10.6 % of cases. In 75 % of positive findings, we detected a Gram-negative bacterium in 65.3 % of cases. In 47.2 % of Staphylococci detected, the ability to produce biofilm was confirmed. 61.1 % of the Staphylococci exhibited a methicillin resistance. Our multiplex scheme cannot yet fully replace microbial cultivation but can be a rational guide when choosing an appropriate antibiotic therapy in cases where the microbial culture is negative.