Multiplex Polymerase Chain Reaction and Microcalorimetry in Synovial Fluid: Can Pathogen-based Detection Assays Improve the Diagnosis of Septic Arthritis?

The Journal of Rheumatology
Christian MorgensternAndrej Trampuz

Abstract

To prospectively evaluate automated multiplex PCR and isothermal microcalorimetry tests for rapid and accurate diagnosis of septic arthritis. Patients with acute arthritis were prospectively included from October 2014 to September 2015. In synovial fluid (SF), leukocyte count and differential, culture, PCR, and microcalorimetry were determined. Septic arthritis was diagnosed by positive SF culture or (1) local clinical signs and symptoms, (2) increased SF leukocyte count, and (3) exclusion of noninfectious causes of inflammatory arthropathy. The performance of individual tests was compared with McNemar's test. Among 57 patients, 22 (39%) were diagnosed with septic arthritis. SF culture grew a pathogen in 10 patients (46%), PCR was positive in 5 (23%), and microcalorimetry in 10 (46%). Compared to SF culture, 49 concordant pairs were found for both methods (PCR and microcalorimetry; 86% agreement). In SF, PCR failed to detect Staphylococcus aureus (2 patients), Streptococcus pneumoniae (1 patient), Streptococcus dysgalactiae (1 patient), and Clostridium clostridioforme (1 patient). Microcalorimetry failed to detect S. dysgalactiae (1 patient), Streptococcus agalactiae (1 patient), and C. clostridioforme (1 patient). No statistic...Continue Reading

Associated Clinical Trials

Aug 21, 2015·Andrej Trampuz

References

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Citations

Nov 6, 2018·The Journal of Rheumatology·Yvonne Achermann, Annelies S Zinkernagel
Jun 5, 2020·BMC Musculoskeletal Disorders·Christian MorgensternAndrej Trampuz
Jan 11, 2021·Journal of Experimental Orthopaedics·Elizabeth H G TurnerAndrea M Spiker
Mar 10, 2021·BMC Musculoskeletal Disorders·Christian MorgensternAndrej Trampuz
Jun 18, 2021·Frontiers in Microbiology·Holger BrüggemannRolf Lood
Dec 22, 2021·Der Unfallchirurg·Jan-Dierk ClausenMohamed Omar

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