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Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
Culture-negative periprosthetic joint infections
Jeya Palan1, Ciaran Nolan1, Kostas Sarantos1
1Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK.
Abstract:
Culture-negative periprosthetic joint infections (CN-PJI) pose a significant challenge in terms of diagnosis and management. The reported incidence of CN-PJI is reported to be between 7% and 15%.Fungi and mycobacterium are thought to be responsible for over 85% of such cases with more fastidious bacteria accounting for the rest.With the advent of polymerase chain reaction, mass spectrometry and next generation sequencing, identifying the causative organism(s) may become easier but such techniques are not readily available and are very costly.There are a number of more straightforward and relatively low-cost methods to help surgeons maximize the chances of diagnosing a PJI and identify the organisms responsible.This review article summarizes the main diagnostic tests currently available as well as providing a simple diagnostic clinical algorithm for CN-PJI. Cite this article: EFORT Open Rev 2019;4:585-594. DOI: 10.1302/2058-5241.4.180067.
Insights
Diagnosing culture-negative periprosthetic joint infections (CN-PJI) is challenging. This review outlines accessible diagnostic methods and a clinical algorithm to improve CN-PJI identification, aiding patient management.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Medical Diagnostics
Background:
- Culture-negative periprosthetic joint infections (CN-PJI) present diagnostic and management difficulties, with an incidence of 7-15%.
- Fungi and mycobacteria are implicated in over 85% of CN-PJI cases, alongside fastidious bacteria.
- Advanced molecular techniques for pathogen identification are often inaccessible and expensive.
Purpose of the Study:
- To review current diagnostic tests for CN-PJI.
- To provide a straightforward clinical algorithm for diagnosing CN-PJI.
- To assist surgeons in maximizing diagnostic accuracy for PJI and identifying causative organisms.
Main Methods:
- Literature review of diagnostic tests for CN-PJI.
- Synthesis of information on established and emerging diagnostic modalities.
- Development of a simplified clinical algorithm for CN-PJI diagnosis.
Main Results:
- Several straightforward, low-cost methods can aid in CN-PJI diagnosis.
- Advanced techniques like PCR and NGS offer potential but face accessibility and cost barriers.
- A practical diagnostic algorithm is proposed to guide clinicians.
Conclusions:
- Accessible diagnostic strategies are crucial for managing CN-PJI effectively.
- The proposed algorithm can improve the identification of causative pathogens in CN-PJI.
- Further research into cost-effective diagnostic tools for CN-PJI is warranted.
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