Clinical usefulness of multiplex PCR-lateral flow for the diagnosis of orthopedic-related infections

Abstract

Objectives: Polymerase chain reaction (PCR)-based assays are being increasingly used for the diagnosis of orthopedic-related infections. Unfortunately, classical PCR requires imaging devices that are expensive and complex. We previously developed the PCR-lateral flow (PCR-LF) method, which does not require any additional imaging device. In the present study, the objective was to determine whether PCR-LF tests could be used to effectively diagnose orthopedic-related infections.

Methods: In this study, we used PCR-LF to diagnose common causes of orthopedic-related infections and compared the results to those from conventional bacterial cultures of the same samples.

Results: Notably, for 228 synovial fluid or pus specimens, the sensitivity and specificity of bacterial cultures were 53.5% and 97.7%, respectively, compared to 61.6% and 89.9% for PCR-LF. Although the difference in sensitivity between bacterial cultures and PCR-LF was not significant, when our analysis was limited to cases with suspected periprosthetic joint infection, the sensitivity of PCR-LF (66.1%) was superior to that of bacterial cultures (42.9%).

Conclusion: This study indicates that PCR-LF is a useful method for diagnosing orthopedic-related infections.

Keywords:

• Lateral flow method
• MRSA
• PCR
• periprosthetic joint infection

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Conflict of interest

None.

Additional information

Funding

This work was supported by Japan Society for the Promotion of Science, JSPS KAKENHI [Grant Number JP15K10489]. The funding source had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.