Diagnosis of Culture-Negative Septic Arthritis with Polymerase Chain Reaction in an Immunosuppressed Patient

2020 ◽  
Vol 10 (3) ◽  
pp. e20.00057-e20.00057
Author(s):  
Zachariah G. Whiting ◽  
Teresa Doerre
Keyword(s):  
Polymerase Chain Reaction ◽  
Septic Arthritis ◽  
Immunosuppressed Patient ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Culture Negative

Performance of automated multiplex polymerase chain reaction (mPCR) using synovial fluid in the diagnosis of native joint septic arthritis in adults

2019 ◽  
Vol 101-B (3) ◽  
pp. 288-296 ◽  
Author(s):  
I. K. Sigmund ◽  
J. Holinka ◽  
F. Sevelda ◽  
K. Staats ◽  
S. Heisinger ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Synovial Fluid ◽  
Septic Arthritis ◽  
Multiplex Polymerase Chain Reaction ◽  
Microbiological Analysis ◽  
Chain Reaction ◽  
Cutibacterium Acnes ◽  
Polymerase Chain ◽  
Synovial Fluid Culture ◽  
Fluid Culture

Aims This study aimed to assess the performance of an automated multiplex polymerase chain reaction (mPCR) technique for rapid diagnosis of native joint septic arthritis Patients and Methods Consecutive patients with suspected septic arthritis undergoing aseptic diagnostic joint aspiration were included. The aspirate was used for analysis by mPCR and conventional microbiological analysis. A joint was classed as septic according to modified Newman criteria. Based on receiver operating characteristic (ROC) analysis, the area under the ROC curve (AUC) values of the mPCR and the synovial fluid culture were compared using the z-test. A total of 72 out of 76 consecutive patients (33 women, 39 men; mean age 64 years (22 to 92)) with suspected septic arthritis were included in this study. Results Of 72 patients, 42 (58%) were deemed to have septic joints. The sensitivity of mPCR and synovial fluid culture was 38% and 29%, respectively. No significant differences were found between the AUCs of both techniques (p = 0.138). A strong concordance of 89% (Cohen’s kappa: 0.65) was shown. The mPCR failed to detect Staphylococcus aureus (n = 1) and Streptococcus pneumoniae (n = 1; no primer included in the mPCR), whereas the synovial fluid culture missed six microorganisms (positive mPCR: S. aureus (n = 2), Cutibacterium acnes (n = 3), coagulase-negative staphylococci (n = 2)). Conclusion The automated mPCR showed at least a similar performance to the synovial fluid culture (the current benchmark) in diagnosing septic arthritis, having the great advantage of a shorter turnaround time (within five hours). Cite this article: Bone Joint J 2019;101-B:288–296.

Clinical Utility of a Polymerase Chain Reaction Assay in Culture-Negative Necrotizing Otitis Externa

2015 ◽  
Vol 36 (4) ◽  
pp. 733-736 ◽  
Author(s):  
Maayan Gruber ◽  
Ariel Roitman ◽  
Ilana Doweck ◽  
Nechama Uri ◽  
Pninit Shaked-Mishan ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Polymerase Chain Reaction Assay ◽  
Otitis Externa ◽  
Clinical Utility ◽  
Chain Reaction ◽  
Necrotizing Otitis Externa ◽  
Polymerase Chain ◽  
Culture Negative

scholarly journals Culture-Negative Endocarditis Diagnosed Using 16S DNA Polymerase Chain Reaction

2012 ◽  
Vol 23 (4) ◽  
pp. 216-218 ◽  
Author(s):  
Stephen Duffett ◽  
Bayan Missaghi ◽  
Peter Daley
Keyword(s):  
Polymerase Chain Reaction ◽  
Dna Polymerase ◽  
Tissue Sample ◽  
Low Grade ◽  
Chain Reaction ◽  
Severe Aortic Regurgitation ◽  
Valve Tissue ◽  
Polymerase Chain ◽  
Dna Pcr ◽  
Culture Negative

16S DNA polymerase chain reaction (PCR) is a molecular amplification technique that can be used to identify bacterial pathogens in culture-negative endocarditis. Bacterial DNA can be isolated from surgically excised valve tissue or from blood collected in EDTA vials. Use of this technique is particularly helpful in identifying the bacterial pathogen in cases of culture-negative endocarditis. A case involving a 48-year-old man who presented with severe aortic regurgitation and a four-month prodrome of low-grade fever is reported. Blood and valve tissue cultures following valve replacement were negative. A valve tissue sample was sent for investigation with 16S DNA PCR, which successfully identifiedStreptococcus salivariusand was interpreted as the true diagnosis. A review of the literature suggests that 16S DNA PCR from valve tissue is a more sensitive diagnostic test than culture. It is also extremely specific, based on a sequence match of at least 500 base pairs.

scholarly journals Polymerase chain reaction, with sequencing, as a diagnostic tool in culture-negative bacterial meningitis

1999 ◽  
Vol 5 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Giordano Dicuonzo ◽  
Giulia Lorino ◽  
Daniela Lilli ◽  
Daniela Rivanera ◽  
Paola Guarino ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Bacterial Meningitis ◽  
Diagnostic Tool ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Culture Negative
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