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Higher accuracy of genotypic identification compared to phenotyping in the diagnosis of coagulase-negative staphylococcus infection in orthopedic surgery.
Muñoz-Gamito, Gema; Cuchí, Eva; Roigé, Jordi; Gómez, Lucía; Jaén, Àngels; Matamala, Alfredo; Pedro-Botet, M Lluïsa; Capdevila, Josep Anton; Anglès, Francesc; Pérez, Josefa.
Afiliación
  • Muñoz-Gamito G; Hospital Universitari Mútua Terrassa, Terrassa, Spain.
  • Cuchí E; Universitat Autònoma de Barcelona, Bellaterra, Spain.
  • Roigé J; Department of Clinical Microbiology, CATLAB, Terrassa, Spain.
  • Gómez L; Department of Molecular Microbiology, CATLAB, Terrassa, Spain.
  • Jaén À; Hospital Universitari Mútua Terrassa, Terrassa, Spain.
  • Matamala A; Fundació per la Recerca Mútua Terrassa, Terrassa, Spain.
  • Pedro-Botet ML; Hospital Universitari Mútua Terrassa, Terrassa, Spain.
  • Capdevila JA; Universitat Autònoma de Barcelona, Bellaterra, Spain.
  • Anglès F; Universitat Autònoma de Barcelona, Bellaterra, Spain.
  • Pérez J; Consorci Sanitari del Maresme, Mataro, Spain.
Infect Dis (Lond) ; 52(12): 883-890, 2020.
Article en En | MEDLINE | ID: mdl-32735157
PURPOSE: To determine whether Repetitive Extragenic Palindromic PCR (rep-PCR) genotyping can improve the diagnosis of coagulase-negative staphylococcal (CoNS) orthopaedic infections in comparison to phenotyping. METHODS: Prospective study comparing the results of phenotypic/genotypic (rep-PCR) testing in patients with suspected CoNS infection. Each strain was analysed using both methods. Strains identified as identical in ≥2 samples were considered as pathogenic. RESULTS: 255 CoNS strains from 52 surgical episodes were included. Infection was diagnosed by phenotyping in 38(73%) cases and by genotyping in 40(77%). The Kappa index was 0.59. Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) for phenotyping (vs. rep-PCR) were: 88%, 75%, 92%, and 64%. 5/14(36%) of cases not considered as true infections by phenotyping were diagnosed as infections with genotyping. In a subgroup of 203 strains from 41 surgical procedures with orthopaedic implants, the kappa index was 0.68. Sensitivity, Specificity, PPV, and NPV for phenotyping were: 93%, 73%, 90% and 80%. Again, 2/10 episodes in which CoNS were considered non-infective by phenotyping were diagnosed as infected by genotyping. CONCLUSIONS: Rep-PCR genotyping can identify identical CoNS strains that differ in their phenotype and should be used as a complementary technique. One-third of infected cases may be misdiagnosed without genotypic analysis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ortopedia / Infecciones Estafilocócicas / Procedimientos Ortopédicos Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Infect Dis (Lond) Año: 2020 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ortopedia / Infecciones Estafilocócicas / Procedimientos Ortopédicos Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Infect Dis (Lond) Año: 2020 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido