Usefulness of broad-range PCR for the diagnosis of osteoarticular infections

被引:55
作者
Fenollar, Florence [2 ]
Levy, Pierre-Yves [2 ]
Raoult, Didier [1 ,2 ]
机构
[1] Univ Mediterranee, CNRS, IRD,URMITE,UMR 6020, Fac Med,Unite Rickettsies,Dept Rickettsiae,IFR48, F-13385 Marseille 05, France
[2] Federat Infect Dis, Marseille, France
关键词
16S rRNA PCR; broad-range PCR; intracellular bacteria; molecular diagnosis; slow-growing bacteria;
D O I
10.1097/BOR.0b013e3283032030
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review Conventional methods such as microbiological cultures may lack the sensitivity and specificity to establish definitive diagnosis of osteoarticular infections. Herein, we review the general principles and the usefulness of broad-range PCR to improve the etiological diagnosis of osteoarticular infections. Recent findings Broad-range PCR followed by sequencing has been successfully developed to identify microorganisms involved in infections when patients have previously received antibiotics or in the presence of slow-growing or intracellular microorganisms. For osteoarticular infections, the studies have shown that the use of this molecular tool increased mainly the identification of Kingella kingae, anaerobic bacteria, and Streptococcus spp. However, it is very important to underline that the interpretation of this molecular tool is critical because of several pitfalls, including contamination causing false-positive results. Summary Broad-range PCR followed by sequencing offers several advantages when used to complement culture results for the diagnosis of fastidious bacteria and for patients taking antibiotics. However, its use should be restricted mainly for culture-negative cases when infection is suspected on the basis of clinical signs and symptoms or inflammatory syndrome. Future developments will include the use of real-time PCR in a closed system and pathogen-specific PCR for the molecular diagnosis of osteoarticular infections.
引用
收藏
页码:463 / 470
页数:8
相关论文
共 60 条
[1]  
Altwegg M, 1996, SCHWEIZ MED WSCHR, V126, P1495
[2]   DETECTION OF ROCHALIMAEA-HENSELAE DNA IN SPECIMENS FROM CAT-SCRATCH DISEASE PATIENTS BY PCR [J].
ANDERSON, B ;
SIMS, K ;
REGNERY, R ;
ROBINSON, L ;
SCHMIDT, MJ ;
GORAL, S ;
HAGER, C ;
EDWARDS, K .
JOURNAL OF CLINICAL MICROBIOLOGY, 1994, 32 (04) :942-948
[3]   In-house nucleic acid amplification assays in research: How much quality control is needed before one can rely upon the results? [J].
Apfalter, P ;
Reischl, U ;
Hammerschlag, MR .
JOURNAL OF CLINICAL MICROBIOLOGY, 2005, 43 (12) :5835-5841
[4]   Bacterial zoonoses and infective endocarditis, Algeria [J].
Benslimani, A ;
Fenollar, F ;
Lepidi, H ;
Raoult, D .
EMERGING INFECTIOUS DISEASES, 2005, 11 (02) :216-224
[5]   False-positive results and contamination in nucleic acid amplification assays: Suggestions for a prevent and destroy strategy [J].
Borst, A ;
Box, ATA ;
Fluit, AC .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2004, 23 (04) :289-299
[6]   Streptococcus pneumoniae endocarditis:: Persistence of DNA on heart valve material 7 years after infectious episode [J].
Branger, S ;
Casalta, JP ;
Habib, G ;
Collard, F ;
Raoult, D .
JOURNAL OF CLINICAL MICROBIOLOGY, 2003, 41 (09) :4435-4437
[7]   Impact of a molecular approach to improve the microbiological diagnosis of infective heart valve endocarditis [J].
Breitkopf, C ;
Hammel, D ;
Scheld, HH ;
Peters, G ;
Becker, K .
CIRCULATION, 2005, 111 (11) :1415-1421
[8]   16S ribosomal DNA sequence analysis of a large collection of environmental and clinical unidentifiable bacterial isolates [J].
Drancourt, M ;
Bollet, C ;
Carlioz, A ;
Martelin, R ;
Gayral, JP ;
Raoult, D .
JOURNAL OF CLINICAL MICROBIOLOGY, 2000, 38 (10) :3623-3630
[9]   Systematic 16S rRNA gene sequencing of atypical clinical isolates identified 27 new bacterial species associated with humans [J].
Drancourt, M ;
Berger, P ;
Raoult, D .
JOURNAL OF CLINICAL MICROBIOLOGY, 2004, 42 (05) :2197-2202
[10]   Analysis of 525 samples to determine the usefulness of PCR amplification and sequencing of the 16S rRNA gene for diagnosis of bone and joint infections [J].
Fenollar, F ;
Roux, V ;
Stein, A ;
Drancourt, M ;
Raoult, D .
JOURNAL OF CLINICAL MICROBIOLOGY, 2006, 44 (03) :1018-1028