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Enrichment of bacteria samples by centrifugation improves the diagnosis of orthopaedics-related infections via real-time PCR amplification of the bacterial methicillin-resistance gene.

Tsuru A, Setoguchi T, Kawabata N, Hirotsu M, Yamamoto T, Nagano S, Yokouchi M, Kakoi H, Kawamura H, Ishidou Y, Tanimoto A, Komiya S - BMC Res Notes (2015)

Bottom Line: In one sample from a patient who developed infectious pseudoarthrosis and two samples from surgical site infections after spine surgery, the mecA gene was detected only by the M-PCR method.In one patient with infectious pseudoarthrosis, one patient with infection after arthroplasty, and two patients with purulent spondylitis, the detection sensitivity of the M-PCR method was increased compared with PCR (clinical sample average: 411.6 times).In addition, the centrifugation process only takes 10 min longer than conventional real-time PCR methods.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. a-tsuru@m2.kufm.kagoshima-u.ac.jp.

ABSTRACT

Background: To effectively treat orthopaedic infections by methicillin-resistant strains, an early diagnosis is necessary. Bacterial cultures and real-time polymerase chain reaction (PCR) have been used to define methicillin-resistant staphylococci. However, even when patients display clinical signs of infections, bacterial culture and real-time PCR often cannot confirm infection. The aim of this study was to prospectively compare the utility of real-time PCR for the mecA gene detection following centrifugation of human samples with suspected orthopaedic infections.

Results: In addition to the conventional real-time PCR method, we performed real-time PCR following centrifugation of the sample at 4,830×g for 10 min in a modified real-time PCR (M-PCR) method. We suspended cultured methicillin-resistant Staphylococcus aureus and generated standard dilution series for in vitro experiments. The in vitro detection sensitivity of the M-PCR method was approximately 5.06 times higher than that of the conventional real-time PCR method. We performed bacterial culture, pathological examination, real-time PCR, and M-PCR to examine the infectious fluids and tissues obtained from 36 surgical patients at our hospital. Of these, 20 patients who had undergone primary total hip arthroplasty were enrolled as negative controls. In addition, 15 patients were examined who were clinically confirmed to have an infection, including periprosthetic joint infection (eight patients), pyogenic spondylitis (two patients), infectious pseudoarthrosis (two patients), and after spine surgery (three patients). In one sample from a patient who developed infectious pseudoarthrosis and two samples from surgical site infections after spine surgery, the mecA gene was detected only by the M-PCR method. In one patient with infectious pseudoarthrosis, one patient with infection after arthroplasty, and two patients with purulent spondylitis, the detection sensitivity of the M-PCR method was increased compared with PCR (clinical sample average: 411.6 times).

Conclusions: These findings suggest that the M-PCR method is useful to detect methicillin-resistant strains infections. In addition, the centrifugation process only takes 10 min longer than conventional real-time PCR methods. We believe that the M-PCR method could be clinically useful to detect orthopaedic infections caused by methicillin-resistant strains.

No MeSH data available.


Related in: MedlinePlus

M-PCR improved the detection of mecA gene in clinical samples. To compare the detection sensitivity of the M-PCR method with the conventional real-time PCR method, we analysed infectious tissues collected from patients. DNA was purified by conventional methods (A) or following centrifugation (B: M-PCR). A comparative Ct (ΔCt) analysis was performed to examine fold changes of the mecA gene. Only M-PCR, but not conventional real-time PCR, detected the mecA gene from three clinically infected samples, including one pseudoarthrosis (a). M-PCR improved the detection of the mecA gene 6.96 times higher than conventional real-time PCR methods (b). The experiment was performed in triplicate with similar results.
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Fig3: M-PCR improved the detection of mecA gene in clinical samples. To compare the detection sensitivity of the M-PCR method with the conventional real-time PCR method, we analysed infectious tissues collected from patients. DNA was purified by conventional methods (A) or following centrifugation (B: M-PCR). A comparative Ct (ΔCt) analysis was performed to examine fold changes of the mecA gene. Only M-PCR, but not conventional real-time PCR, detected the mecA gene from three clinically infected samples, including one pseudoarthrosis (a). M-PCR improved the detection of the mecA gene 6.96 times higher than conventional real-time PCR methods (b). The experiment was performed in triplicate with similar results.

Mentions: We analysed the effusion, joint fluid, or infectious tissues from the infectious sites. The demographic data are summarized in Additional file 1: Table S1. Conventional PCR and M-PCR did not detect the mecA gene from control primary THA samples. Only M-PCR, and not conventional PCR, detected the mecA gene from three clinically infected samples, including one pseudoarthrosis and two surgical site infections following spine surgery (Figure 3). In seven samples, detection of the mecA gene was improved by M-PCR. Overall, M-PCR improved detection of the mecA gene 411.6 (average) times than was achieved with conventional real-time PCR. There was statistical difference between M-PCR and conventional real-time PCR (p < 0.05). The results for all of the clinical samples are summarized in Additional file 2: Table S2.Figure 3


Enrichment of bacteria samples by centrifugation improves the diagnosis of orthopaedics-related infections via real-time PCR amplification of the bacterial methicillin-resistance gene.

Tsuru A, Setoguchi T, Kawabata N, Hirotsu M, Yamamoto T, Nagano S, Yokouchi M, Kakoi H, Kawamura H, Ishidou Y, Tanimoto A, Komiya S - BMC Res Notes (2015)

M-PCR improved the detection of mecA gene in clinical samples. To compare the detection sensitivity of the M-PCR method with the conventional real-time PCR method, we analysed infectious tissues collected from patients. DNA was purified by conventional methods (A) or following centrifugation (B: M-PCR). A comparative Ct (ΔCt) analysis was performed to examine fold changes of the mecA gene. Only M-PCR, but not conventional real-time PCR, detected the mecA gene from three clinically infected samples, including one pseudoarthrosis (a). M-PCR improved the detection of the mecA gene 6.96 times higher than conventional real-time PCR methods (b). The experiment was performed in triplicate with similar results.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4490765&req=5

Fig3: M-PCR improved the detection of mecA gene in clinical samples. To compare the detection sensitivity of the M-PCR method with the conventional real-time PCR method, we analysed infectious tissues collected from patients. DNA was purified by conventional methods (A) or following centrifugation (B: M-PCR). A comparative Ct (ΔCt) analysis was performed to examine fold changes of the mecA gene. Only M-PCR, but not conventional real-time PCR, detected the mecA gene from three clinically infected samples, including one pseudoarthrosis (a). M-PCR improved the detection of the mecA gene 6.96 times higher than conventional real-time PCR methods (b). The experiment was performed in triplicate with similar results.
Mentions: We analysed the effusion, joint fluid, or infectious tissues from the infectious sites. The demographic data are summarized in Additional file 1: Table S1. Conventional PCR and M-PCR did not detect the mecA gene from control primary THA samples. Only M-PCR, and not conventional PCR, detected the mecA gene from three clinically infected samples, including one pseudoarthrosis and two surgical site infections following spine surgery (Figure 3). In seven samples, detection of the mecA gene was improved by M-PCR. Overall, M-PCR improved detection of the mecA gene 411.6 (average) times than was achieved with conventional real-time PCR. There was statistical difference between M-PCR and conventional real-time PCR (p < 0.05). The results for all of the clinical samples are summarized in Additional file 2: Table S2.Figure 3

Bottom Line: In one sample from a patient who developed infectious pseudoarthrosis and two samples from surgical site infections after spine surgery, the mecA gene was detected only by the M-PCR method.In one patient with infectious pseudoarthrosis, one patient with infection after arthroplasty, and two patients with purulent spondylitis, the detection sensitivity of the M-PCR method was increased compared with PCR (clinical sample average: 411.6 times).In addition, the centrifugation process only takes 10 min longer than conventional real-time PCR methods.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. a-tsuru@m2.kufm.kagoshima-u.ac.jp.

ABSTRACT

Background: To effectively treat orthopaedic infections by methicillin-resistant strains, an early diagnosis is necessary. Bacterial cultures and real-time polymerase chain reaction (PCR) have been used to define methicillin-resistant staphylococci. However, even when patients display clinical signs of infections, bacterial culture and real-time PCR often cannot confirm infection. The aim of this study was to prospectively compare the utility of real-time PCR for the mecA gene detection following centrifugation of human samples with suspected orthopaedic infections.

Results: In addition to the conventional real-time PCR method, we performed real-time PCR following centrifugation of the sample at 4,830×g for 10 min in a modified real-time PCR (M-PCR) method. We suspended cultured methicillin-resistant Staphylococcus aureus and generated standard dilution series for in vitro experiments. The in vitro detection sensitivity of the M-PCR method was approximately 5.06 times higher than that of the conventional real-time PCR method. We performed bacterial culture, pathological examination, real-time PCR, and M-PCR to examine the infectious fluids and tissues obtained from 36 surgical patients at our hospital. Of these, 20 patients who had undergone primary total hip arthroplasty were enrolled as negative controls. In addition, 15 patients were examined who were clinically confirmed to have an infection, including periprosthetic joint infection (eight patients), pyogenic spondylitis (two patients), infectious pseudoarthrosis (two patients), and after spine surgery (three patients). In one sample from a patient who developed infectious pseudoarthrosis and two samples from surgical site infections after spine surgery, the mecA gene was detected only by the M-PCR method. In one patient with infectious pseudoarthrosis, one patient with infection after arthroplasty, and two patients with purulent spondylitis, the detection sensitivity of the M-PCR method was increased compared with PCR (clinical sample average: 411.6 times).

Conclusions: These findings suggest that the M-PCR method is useful to detect methicillin-resistant strains infections. In addition, the centrifugation process only takes 10 min longer than conventional real-time PCR methods. We believe that the M-PCR method could be clinically useful to detect orthopaedic infections caused by methicillin-resistant strains.

No MeSH data available.


Related in: MedlinePlus