Specific staphylococcal polymerase chain reaction can be a complementary tool for identifying causative organisms and guiding antibiotic management in orthopaedic infections

Abstract

Background Vast numbers of bone and joint infections in adults, including prosthetic joint infections, are caused by staphylococci. Because of the complexity of these infections, treatment with broad-spectrum antibiotics active against staphylococci usually is started before sampling. This may be one of the reasons why conventional microbiology cultures fail to identify a causative organism. We sought to demonstrate that a specific duplex Staphylococcus species real-time polymerase chain reaction can aid in the diagnosis and antimicrobial management of these cases. Methods Deep specimens from 19 patients with presumed bone, joint, or prosthetic joint infection, who had been on anti-staphylococcal antibiotics before surgery, were examined with a specific duplex staphylococcal polymerase chain reaction. Samples including bone, tissue, joint aspirates and fluid were negative on culture using conventional microbiology techniques. Results The polymerase chain reaction resulted in bacteriological identification in 58.7% of the samples and antibiotic treatment was modified accordingly. Conclusions Specific staphylococcal polymerase chain reaction can be a useful diagnostic tool in orthopaedic infections especially when conventional cultures fail to grow, this would allow targeted antibiotic therapy.