关节置换术后假体周围感染分子生物学诊断研究进展

Novel molecular biology developments in diagnosis of periprosthetic joint infection following total joint arthroplasty

假体周围感染是关节置换术后的常见并发症,也是灾难性并发症,严重影响患者日常生活质量,加重其社会、经济负担。假体周围感染及时、正确的诊断对后续治疗至关重要。目前常规检查方法有血清学检查、关节液检查及术中组织学检查。多个相关协会和组织亦发布假体周围感染的诊断指南以指导临床工作。但对于细菌培养阴性、之前使用抗生素、生物膜形成及低毒力细菌感染等患者,常规诊断方法效果欠佳。近年来假体周围感染分子生物学诊断的研究大量涌现,本文对此方面的研究进展简要综述。

As the number of total joint arthroplasty(TJA) continues to rise, the periprosthetic joint infection(PJI) following TJA, a common and devastating complication, become a significant public health concern due to increasing burden of this complication and its tremendous impact on patients. The timely detection of the presence of infection and the identification of the pathogen are the two most important factors in the diagnosis of PJI. The routine diagnostic tests for the detection of PJI include serological, synovial and intraoperative tissue examinations. These traditional tests have been combined into an algorithm of major and minor criteria for the definition of PJI by many groups of infection societies. However, the routine examinations become inefficient to the patients with a negative culture caused by previous antibiotic therapy, bacterial biofilm formation and low virulence strain infection. In recent years, molecular biology technologies for diagnosis of PJI have drawn greater attention by exploring molecular machination of infection. In this article, the recent development of molecular biology technologies for diagnosis of PJI was reviewed.