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bbFISH-ing in the sonication fluid.

Rares Mircea Birlutiu1, Victoria Birlutiu2, Razvan Silviu Cismasiu3

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Prosthetic joint infections (PJIs) are a common complication of hip and knee replacements. A new diagnostic strategy using sonication and beacon-based fluorescent in situ hybridization (bbFISH) shows promise for rapid PJI detection.

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Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Medical Diagnostics

Background:

  • Total hip and knee arthroplasty numbers are rising, increasing the risk of prosthetic joint infections (PJIs).
  • PJIs are a significant cause of morbidity and healthcare costs, necessitating rapid and accurate diagnosis.
  • Current diagnostic methods can be time-consuming, delaying appropriate treatment.

Purpose of the Study:

  • To evaluate a novel diagnostic strategy for PJIs using sonication fluid and beacon-based fluorescent in situ hybridization (bbFISH).
  • To assess the efficacy of bbFISH compared to traditional culture methods for PJI diagnosis.
  • To identify potential improvements for rapid PJI detection in clinical settings.

Main Methods:

  • A new PJI diagnostic strategy was implemented in September 2016, utilizing sonication and bbFISH technology.
  • Sonication fluid (SF) was collected from 40 retrieved implants between September 2016 and November 2017.
  • SF samples were analyzed using aerobic and anaerobic cultures and bbFISH for rapid bacteria detection.

Main Results:

  • Out of 40 patients, 16 were diagnosed with PJIs, all confirmed by positive SF culture.
  • bbFISH correctly identified PJIs in 11 samples (true-positive).
  • The bbFISH assay did not detect Pseudomonas fluorescens or Ralstonia pickettii, indicating a need for assay optimization.

Conclusions:

  • Sonication fluid culture remains the gold standard for PJI diagnosis.
  • bbFISH shows potential as a rapid diagnostic tool for PJIs.
  • Optimization of the bbFISH assay is required to include a broader range of clinically relevant bacterial strains for improved PJI detection.