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The Archives of Bone and Joint Surgery، جلد ۱۲، شماره ۲، صفحات ۱۰۲-۱۰۷
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عنوان انگلیسی Quantitative Real-Time Polymerase Chain Reaction May Serve as a Useful Adjunct to Conventional Culture in The Detection of Cutibacterium acnes in the Glenohumeral Joint: A Study of 100 Consecutive Patients
چکیده انگلیسی مقاله Objectives: Synovial fluid or tissue culture is the current gold standard for diagnosis of infection, but Cutibacterium acnes (C. acnes) is a frequent cause of shoulder PJI and is a notoriously fastidious organism. The purpose of this study was to compare quantitative real-time polymerase chain reaction (qRT-PCR) to standard culture as a more rapid, sensitive means of identifying C. acnes from the glenohumeral joint. We hypothesized that qRT-PCR would be more effective than standard culture at identifying C. acnes and would have greater sensitivity and specificity for detecting infection.Methods: This was a prospective observational study with 100 consecutive patients undergoing arthroscopic or open shoulder surgery with known positive and negative controls. Intraoperatively, synovial fluid and tissue was obtained for C. acnes qRT-PCR and results were blinded to the gold standard microbiology cultures.Results: Clinical review demonstrated 3 patients (3%) with positive cultures, none of which were positive for C. acnes. Of the samples tested by the C. acnes qRT-PCR standard curve, 12.2% of tissue samples and 4.5% of fluid samples were positive. Culture sensitivity was 60.0%, specificity was 100.0%, PPV was 100.0%, and NPV was 97.9%. C. acnes qRT-PCR standard curve sensitivity, specificity, PPV, and NPV was 60.0%, 90.3%, 25.0%, and 97.7% respectively for tissue specimens and 0%, 95.2%, 0%, and 95.2% respectively, for fluid specimens. For combination of culture and tissue qRT-PCR, the sensitivity, specificity, PPV and NPV was 100%, 90.3%, 35.7%, and 100%, respectively.Conclusion: We report that qRT-PCR for C. acnes identified the organism more frequently than conventional culture. While these findings demonstrate the potential utility of qRT-PCR, the likelihood of false positive results of qRT-PCR should be considered. Thus, qRT-PCR may be useful as an adjuvant to current gold standard workup of synovial fluid or tissue culture for the diagnosis of infection. Level of evidence: II
کلیدواژه‌های انگلیسی مقاله cutibacterium acnes, Periprosthetic joint infection, Polymerase chain reaction, Shoulder Arthroplasty, Shoulder arthroscopy
نویسندگان مقاله | Matthew Como
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA


| Rajiv Reddy
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA


| Margaret Hankins
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA


| Gillian Kane
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA


| Dongzhu Ma
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA


| Peter Alexander
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA


| Kenneth Urish
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA


| Amin Karimi
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA


| Albert Lin
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
نشانی اینترنتی https://abjs.mums.ac.ir/article_23698.html
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نوع مقاله منتشر شده RESEARCH PAPER
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