Efficacy of 16S rRNA variable regions high-resolution melt analysis for bacterial pathogens identification in periprosthetic joint infections

Samaneh Bourbour,Mohamad Naghi Tahmasebi,Fereshteh Jabalameli,Arash Sharafatvaziri,Seyed Mohammad Javad Mortazavi,Amirheckmat Taghizadeh,Mohammad Emaneini,Reza Beigverdi,Mahmoud Jabalameli

doi:10.1186/s12866-021-02164-8

Abstract

BackgroundAccurate and rapid identification of microorganisms causing periprosthetic joint infections (PJIs) are necessary for choosing an appropriate antibiotic therapy. Therefore, molecular techniques are suggested for diagnosis in suspected PJIs. The Broad-range PCR and High-Resolution Melt Analysis (HRMA) were evaluated for the identification of causative organisms of PJIs in this study.ResultsFor 47 of 63 specimens, both the culture and broad-range PCR were positive. The culture was found to be able of organism’s detection in 74.6% (47/63) of patients. Of 47 positive cultures, 11 (23.4%) were polymicrobial and 36 (76.59%) were monomicrobial cultures, in which 34 (91.89%) cases were detected by HRM assay. The sensitivity, specificity of HRMA vs monomicrobial culture were 91.89, 93.75%, respectively. The sensitivity, specificity of total HRMA (mono + poly) vs culture were 82.92, 93.75%.ConclusionsHRM assay coupled with broad-range PCR are effective screening, rapid, and relatively cost-effective methods for discrimination of PJIs especially in aiding culture method. Using computer programs such as the Matlab-2018b program for HRM data analysis is also valuable and helpful in diagnosis.

Highlights

Accurate and rapid identification of microorganisms causing periprosthetic joint infections (PJIs) are necessary for choosing an appropriate antibiotic therapy
The specimens consisted of 39 synovial fluids and 24 tissues
The culture method was found to be able of detection of microorganisms in 74.6% (47/63) of patients as determined by the Philadelphia Consensus Criteria (PCC) and clinician’s diagnosis

Summary

Introduction

Accurate and rapid identification of microorganisms causing periprosthetic joint infections (PJIs) are necessary for choosing an appropriate antibiotic therapy. Periprosthetic joint infections (PJIs), are among important threats to global public health and are considered as a main challenge after elective surgical procedures [1, 2]. Arthroplasty is a frequent surgical procedure for joint replacement in end-stage arthritis [3, 4]. Given the projected increase of joint replacement over the coming decades turned into a challenging issue, such as diagnosis challenges, high morbidity, the economic burden for patients and healthcare costs [5, 8, 9]. In managing PJI, one of the most important aspects is a prompt and definitive diagnosis of the causative organisms for the selection of appropriate treatment options and avoiding unnecessary multiple surgical procedures.

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Conclusion