scholarly journals A Review of the Literature on Culture-Negative Periprosthetic Joint Infection: Epidemiology, Diagnosis and Treatment

2017 ◽  
Vol 29 (3) ◽  
pp. 155-164 ◽  
Author(s):  
Hong-Kwon Yoon ◽  
Seong-Hee Cho ◽  
Dong-Yeong Lee ◽  
Byeong-Hun Kang ◽  
Sang-Hyuk Lee ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Diagnosis And Treatment ◽  
Review Of The Literature ◽  
Culture Negative

Culture-negative periprosthetic joint infection: prevalence, aetiology, evaluation, recommendations, and treatment

2020 ◽  
Vol 44 (7) ◽  
pp. 1255-1261
Author(s):  
Irene Kalbian ◽  
Jung Wee Park ◽  
Karan Goswami ◽  
Young-Kyun Lee ◽  
Javad Parvizi ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Infection Prevalence ◽  
Culture Negative

Culture-Negative Periprosthetic Joint Infection

2014 ◽  
Vol 96 (5) ◽  
pp. 430-436 ◽  
Author(s):  
Javad Parvizi ◽  
Omer Faruk Erkocak ◽  
Craig J Della Valle
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Culture Negative

scholarly journals Correction to: Twenty common errors in the diagnosis and treatment of periprosthetic joint infection

2019 ◽  
Vol 44 (3) ◽  
pp. 603-603 ◽  
Author(s):  
Cheng Li ◽  
Nora Renz ◽  
Andrej Trampuz ◽  
Cristina Ojeda-Thies
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Diagnosis And Treatment

scholarly journals Twenty common errors in the diagnosis and treatment of periprosthetic joint infection

2019 ◽  
Vol 44 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Cheng Li ◽  
Nora Renz ◽  
Andrej Trampuz ◽  
Cristina Ojeda-Thies
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Treatment Success ◽  
Diagnostic Errors ◽  
Diagnosis And Treatment ◽  
Reactive Protein ◽  
Orthopedic Surgeons ◽  
Individualize Treatment ◽  
Infectious Disease Specialists ◽  
Multidisciplinary Teamwork

Abstract Background Misconceptions and errors in the management of periprosthetic joint infection (PJI) can compromise the treatment success. The goal of this paper is to systematically describe twenty common mistakes in the diagnosis and management of PJI, to help surgeons avoid these pitfalls. Materials and methods Common diagnostic and treatment errors are described, analyzed and interpreted. Results Diagnostic errors include the use of serum inflammatory biomarkers (such as C-reactive protein) to rule out PJI, incomplete evaluation of joint aspirate, and suboptimal microbiological procedures (such as using swabs or collection of insufficient number of periprosthetic samples). Further errors are missing possible sources of distant infection in hematogenous PJI or overreliance on suboptimal diagnostic criteria which can hinder or delay the diagnosis of PJI or mislabel infections as aseptic failure. Insufficient surgical treatment or inadequate antibiotic treatment are further reasons for treatment failure and emergence of antimicrobial resistance. Finally, wrong surgical indication, both underdebridement and overdebridement or failure to individualize treatment can jeopardize surgical results. Conclusion Multidisciplinary teamwork with infectious disease specialists and microbiologists in collaboration with orthopedic surgeons have a synergistic effect on the management of PJI. An awareness of the possible pitfalls can improve diagnosis and treatment results.

scholarly journals Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mel S. Lee ◽  
Wen-Hsin Chang ◽  
Su-Chin Chen ◽  
Pang-Hsin Hsieh ◽  
Hsin-Nung Shih ◽  
...  
Keyword(s):  
16S Rrna ◽  
Molecular Diagnosis ◽  
Ribosomal Rna ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
16S Ribosomal Rna ◽  
Purulent Discharge ◽  
Fistula Tract ◽  
Culture Negative

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.

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