Correlation of Culture Results and Hematological Parameters with Tissue PCR Test in the Diagnosis of Periprosthetic Joint Infection

Periprostetik Enfeksiyonlarda Diagnostik Yöntem

Abstract

Objective. Detection of the pathogen and appropriate early treatment are very important in the treatment of periprosthetic joint infection (PJI). In our study, we evaluated the correlation of culture results and hematologic parameters with tissue polymerase chain reaction (PCR) test in the diagnosis of PJI.

Methods. The study included 26 patients whose culture and tissue PCR samples were examined with suspicion of PJI in our clinic. Tissue samples were obtained for PCR and culture during revision surgery.  All data were statistically analyzed. Cut-off values of acute phase reactants were tried to be determined according to the culture results. Pathogens were detected in only one patient in culture, whereas pathogens were detected in 5 patients in PCR test.

Results. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values of patients with positive PCR test results were significantly higher than those with negative PCR test results. As a result of the ROC analysis performed to determine the cut-off values, the cut-off value of CRP was 24.5 with 100.0% sensitivity and 90.0% specificity (p<0.05), and the cut-off value of ESR was 64.5 with 80.0% sensitivity and 85.7% specificity (p<0.05).

Conclusions. Diagnosing infection with PCR test reduces the possibility of making mistakes. In addition, we tried to find the cut-off values for CRP and ESR in the diagnosis of PJI in our study. To confirm these cut-off values we need prospective studies with larger number of patients.