{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:05:46Z","timestamp":1789491946557,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,7,21]],"date-time":"2024-07-21T00:00:00Z","timestamp":1721520000000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Pathogen identification is key in the treatment of septic arthritis (SA) and periprosthetic joint infections (PJI). This study evaluates the outcome of the application of a new, score\u2010based SA and PJI diagnostic algorithm, which includes the execution of molecular testing on synovial fluid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A score\u2010based diagnostic algorithm, which includes serologic and synovial fluid markers determination using multiplex PCR (mPCR) and Next Generation Sequencing (NGS) molecular testing, has been applied to a consecutive series of patients with clinically suspected SA or PJI. Patients with a score \u22656 underwent synovial fluid molecular testing, together with traditional culture, to identify the pathogen and its genetically determined antibiotic resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and seventeen joints in 117 patients (62.5% women; average age 73 years) met the criteria for possible SA\/PJI. The affected joint was the knee in 87.5% (joint replacement 66.5%; native joint 21%) and the hip in 12.5% (all replaced joints). 43\/117 patients (36.7%) were ultimately diagnosed with SA\/PJI. Among the various testing technologies applied, mPCR was the main determinant for pathogen identification in 63%, standard culture in 26%, and mNGS in 11%.\u00a0\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      \u00a0and\n                      <jats:italic>Enterococcus faecalis<\/jats:italic>\n                      were the top two microorganisms identified by mPCR, while\u00a0\n                      <jats:italic>Staphylococcus epidermidis<\/jats:italic>\n                      \u00a0was the prevalent organism identified by NGS. mPCR detected the presence\/absence of the genetically determined antibiotic resistance of all identified microorganisms. The average timeframe for pathogen identification was 3.13\u2009h for mPCR, 4.5 days for culture, and 3.2 days for NGS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Molecular diagnostic technologies represent an innovative screening for fast microorganism identification when a joint infection is clinically suspected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.12097","type":"journal-article","created":{"date-parts":[[2024,7,21]],"date-time":"2024-07-21T03:13:12Z","timestamp":1721531592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Multiplex PCR in septic arthritis and periprosthetic joint infections microorganism identification: Results from the application of a new molecular testing diagnostic algorithm"],"prefix":"10.1002","volume":"11","author":[{"given":"Stefano","family":"Ghirardelli","sequence":"first","affiliation":[{"name":"S\u00fcdtiroler Sanit\u00e4tsbetrieb  Brixen Italy"},{"name":"Paracelsus Medical University (PMU), Institute of Biomechanics Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Scaggiante","sequence":"additional","affiliation":[{"name":"S\u00fcdtiroler Sanit\u00e4tsbetrieb  Brixen Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Troi","sequence":"additional","affiliation":[{"name":"S\u00fcdtiroler Sanit\u00e4tsbetrieb  Brixen Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieralberto","family":"Valpiana","sequence":"additional","affiliation":[{"name":"S\u00fcdtiroler Sanit\u00e4tsbetrieb  Brixen Italy"},{"name":"Paracelsus Medical University (PMU), Institute of Biomechanics Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cristofolini","sequence":"additional","affiliation":[{"name":"S\u00fcdtiroler Sanit\u00e4tsbetrieb  Brixen Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Aloisi","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica, Sanita' Pubblica, Scienze della Vita e dell'Ambiente Universita' degli Studi dell'Aquila  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Violante","sequence":"additional","affiliation":[{"name":"Ospedale Isola Tiberina, Gemelli Isola UOC Chirurgia Protesica e Traumatologica  Rome 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