Rapid and sensitive detection of methicillin-resistant Staphylococcus periprosthetic infections using real-time polymerase chain reaction

The aim of this study was to validate the accuracy, sensitivity, and specificity of a methicillin-resistant Staphylococcus (MRS) real-time polymerase chain reaction (PCR) assay in clinical periprosthetic infection cases. A total of 36 cases of revision arthroplasty were enrolled in this prospective study, and the primer and probe set of a methicillin-resistant Staphylococcus aureus detection kit were used for the specific detection of the MecA gene with a LightCycler system. The specimens were also tested in microbiologic cultures and histopathologic evaluations. Of the 36 cases tested, 14 were found to be PCR positive for MRS infection. Of these 14 cases, however, only 8 were also found to be MRS infected using the culture method, whereas 3 were culture negative and 3 samples showed growth of another organism. The accuracy, sensitivity, and specificity were 0.83, 1.00, and 0.79, respectively. We conclude that the use of this approach will improve the diagnosis of MRS having a direct impact in the management of cases of periprosthetic infections. (C) 2009 Elsevier Inc. All rights reserved.