Performance of the GeneXpert® MRSA/SA SSTI ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Performance of the GeneXpert® MRSA/SA SSTI Test in Periprosthetic Joint Infections: Rate of failure, Outcomes and Risk Factors.
Author(s) :
Leclerc, Jean-Thomas [Auteur]
Université de Lille
Titecat, Marie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Martin, Theo [Auteur]
Université de Lille
Dartus, Julien [Auteur]
Université de Lille
Putman, Sophie [Auteur]
Université de Lille
Martinot, Pierre [Auteur]
Université de Lille
Demaeght, François [Auteur]
Université de Lille
Loiez, Caroline [Auteur]
Université de Lille
Faure, Pierre-Alexandre [Auteur]
Université de Lille
Pasquier, Gilles [Auteur]
Université de Lille
Girard, Julien [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Senneville, Eric [Auteur]
Université de Lille
Migaud, Henri [Auteur]
Université de Lille
Université de Lille
Titecat, Marie [Auteur]

Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Martin, Theo [Auteur]
Université de Lille
Dartus, Julien [Auteur]
Université de Lille
Putman, Sophie [Auteur]

Université de Lille
Martinot, Pierre [Auteur]
Université de Lille
Demaeght, François [Auteur]
Université de Lille
Loiez, Caroline [Auteur]
Université de Lille
Faure, Pierre-Alexandre [Auteur]
Université de Lille
Pasquier, Gilles [Auteur]

Université de Lille
Girard, Julien [Auteur]

Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Senneville, Eric [Auteur]

Université de Lille
Migaud, Henri [Auteur]

Université de Lille
Journal title :
Orthopaedics & Traumatology: Surgery & Research
Abbreviated title :
Orthop Traumatol Surg Res
Pages :
104032
Publisher :
Elsevier
Publication date :
2024-11-18
ISSN :
1877-0568
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background
The GeneXpert® MRSA/SA SSTI test allows early detection of methicillin-resistant staphylococci in intraoperative samples of prosthetic joint infections (PJI) in order to stop early broad-spectrum antibiotics. ...
Show more >Background The GeneXpert® MRSA/SA SSTI test allows early detection of methicillin-resistant staphylococci in intraoperative samples of prosthetic joint infections (PJI) in order to stop early broad-spectrum antibiotics. Questions/Purpose (1) What is the rate of false-negative GeneXpert® MRSA/SA SSTI test results? (2) Does a false-negative GeneXpert® MRSA/SA SSTI test result increase the risk of treatment failure for the patient with a PJI? (3) What are the risk factors of a false-negative result? Method A retrospective study was carried out to compare all GeneXpert® assays to conventional cultures in prosthetic joint infections from April 1st, 2012 to October 1st, 2016. False-negative (FN) results (absence of methicillin-resistant staphylococci (MRS) with GeneXpert® test, but presence in the culture) were identified. We compared the rate of treatment failure between FN results and other test results and we established the risk factors of having a FN result. Results Among the 612 GeneXpert® results, the rate of FN results was 3.6 % (22/612). We found a significant increase in treatment failures for prosthetic joint infection with a FN result with 14 treatment failures (14/22) compared to 198 treatment failures (198/590) in the other test results (OR, 2.1; 95 % CI, 1.3-3.4, p = 0.0019). Not considering suppressive antibiotics as a treatment failure, we found no significant difference in the rate of treatment failures between the false-negative tests and the other tests (OR, 1.36; 95 % CI, 0.66-2.81, p = 0.41). Tobacco use (OR, 3.8; 95 % CI, 1.4-10.3, p = 0.004), ASA classification (OR, 2,4; 95 % CI, 0.9-6.9, p = 0.064), history of infection in the joint (OR, 3.2; 95 % CI, 1.2-9.6, p = 0.007), chronic infections (OR, 3.2; 95 % CI, 0.8-17.5, p = 0.01) and polymicrobial infections (OR, 3.2; 95 % CI, 1.1-9.2, p < 0.0001) were risk factors for a FN result. Conclusion GeneXpert® tests in prosthetic joint infections showed a low rate of FN results. An increased risk of treatment failures was observed in FN results only when long-term use of suppressive antibiotics was considered as treatment failure.Show less >
Show more >Background The GeneXpert® MRSA/SA SSTI test allows early detection of methicillin-resistant staphylococci in intraoperative samples of prosthetic joint infections (PJI) in order to stop early broad-spectrum antibiotics. Questions/Purpose (1) What is the rate of false-negative GeneXpert® MRSA/SA SSTI test results? (2) Does a false-negative GeneXpert® MRSA/SA SSTI test result increase the risk of treatment failure for the patient with a PJI? (3) What are the risk factors of a false-negative result? Method A retrospective study was carried out to compare all GeneXpert® assays to conventional cultures in prosthetic joint infections from April 1st, 2012 to October 1st, 2016. False-negative (FN) results (absence of methicillin-resistant staphylococci (MRS) with GeneXpert® test, but presence in the culture) were identified. We compared the rate of treatment failure between FN results and other test results and we established the risk factors of having a FN result. Results Among the 612 GeneXpert® results, the rate of FN results was 3.6 % (22/612). We found a significant increase in treatment failures for prosthetic joint infection with a FN result with 14 treatment failures (14/22) compared to 198 treatment failures (198/590) in the other test results (OR, 2.1; 95 % CI, 1.3-3.4, p = 0.0019). Not considering suppressive antibiotics as a treatment failure, we found no significant difference in the rate of treatment failures between the false-negative tests and the other tests (OR, 1.36; 95 % CI, 0.66-2.81, p = 0.41). Tobacco use (OR, 3.8; 95 % CI, 1.4-10.3, p = 0.004), ASA classification (OR, 2,4; 95 % CI, 0.9-6.9, p = 0.064), history of infection in the joint (OR, 3.2; 95 % CI, 1.2-9.6, p = 0.007), chronic infections (OR, 3.2; 95 % CI, 0.8-17.5, p = 0.01) and polymicrobial infections (OR, 3.2; 95 % CI, 1.1-9.2, p < 0.0001) were risk factors for a FN result. Conclusion GeneXpert® tests in prosthetic joint infections showed a low rate of FN results. An increased risk of treatment failures was observed in FN results only when long-term use of suppressive antibiotics was considered as treatment failure.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
Univ. Artois
Univ. Littoral Côte d’Opale
Univ. Artois
Univ. Littoral Côte d’Opale
Submission date :
2024-11-20T22:06:12Z
2024-12-11T07:54:05Z
2024-12-11T07:54:05Z