Beschreibung:
<jats:title>ABSTRACT</jats:title>
<jats:p>
We developed and evaluated a multiplex antibody detection-based immunoassay for the diagnosis of prosthetic joint infections (PJIs). Sixteen protein antigens from three
<jats:named-content content-type="genus-species">Staphylococcus</jats:named-content>
species (
<jats:named-content content-type="genus-species">Staphylococcus aureus</jats:named-content>
,
<jats:named-content content-type="genus-species">Staphylococcus epidermidis</jats:named-content>
, and
<jats:named-content content-type="genus-species">Staphylococcus lugdunensis</jats:named-content>
) (8 antigens),
<jats:named-content content-type="genus-species">Streptococcus agalactiae</jats:named-content>
(4 antigens), and
<jats:named-content content-type="genus-species">Propionibacterium acnes</jats:named-content>
(4 antigens) were selected by comparative immunoproteomics using serum samples from PJI cases versus controls. A bead-based multiplex immunoassay that measured serum IgG against purified, recombinant forms of each of the 16 antigens was developed. We conducted a prospective study to evaluate the performance of the assay. A PJI was defined by the presence of a sinus tract and/or positive intraoperative sample cultures (at least one sample yielding a virulent organism or at least two samples yielding the same organism). A total of 455 consecutive patients undergoing revision or resection arthroplasty (hip, 66.3%; knee, 29.7%; shoulder, 4%) at two French reference centers for the management of PJI were included: 176 patients (38.7%) were infected and 279 (61.3%) were not. About 60% of the infections involved at least one of the species targeted by the assay. The sensitivity/specificity values were 72.3%/80.7% for targeted staphylococci, 75%/92.6% for
<jats:named-content content-type="genus-species">S. agalactiae</jats:named-content>
, and 38.5%/84.8% for
<jats:named-content content-type="genus-species">P. acnes</jats:named-content>
. The assay was more sensitive for infections occurring >3 months after arthroplasty and for patients with an elevated C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR). However, it detected 64.3% and 58.3% of targeted staphylococcal infections associated with normal CRP and ESR values, respectively. This new multiplex immunoassay approach is a novel noninvasive tool to evaluate patients suspected of having PJIs and provides information complementary to that from inflammatory marker values.
</jats:p>