Identification of Pathogens in Bone and Joint Infections by Non‐Culture Techniques

Abstract

Despite the correct implementation of special diagnostic culture techniques, such as tissue sample processing with beadmill, prolonged incubation time, or sonication of removed implants, a considerable number of bone and joint infections (BJI) are either culture-negative or misjudged as aseptic failure. In this chapter, the authors describe non-culture techniques based on nucleic acid amplification, sequencing, and mass-spectrometry methods. Polymerase chain reaction (PCR) is a frequently used technique in most microbiology laboratories that allows detection of a nucleic acid fragment by amplifying a sequence. There are different PCR types that can be used in the BJI diagnosis. These include broad-range PCR, targeted or specific PCR, and multiplex PCR. Pathogens can be identified even if genus or species are unknown using universal primers to amplify bacterial or fungal DNA, followed by the identification of the species by sequencing, a technique which is also called universal PCR.