{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:12:24Z","timestamp":1779192744795,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2016,10,17]],"date-time":"2016-10-17T00:00:00Z","timestamp":1476662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2016,10,17]],"date-time":"2016-10-17T00:00:00Z","timestamp":1476662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Genetic Testing and Molecular Biomarkers"],"published-print":{"date-parts":[[2016,12,1]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background:<\/jats:italic>\n                    Preliminary studies have identified known bacterial pathogens in the knees of patients with osteoarthritis (OA) before arthroplasty.\n                    <jats:italic toggle=\"yes\">Aims:<\/jats:italic>\n                    The current study was designed to determine the incidence and types of bacteria present in the synovial fluid of native knee joints from adult patients with diagnoses of septic arthritis and OA.\n                    <jats:italic toggle=\"yes\">Patients and Methods:<\/jats:italic>\n                    Patients were enrolled between October 2010 and January 2013. Synovial fluid samples from the affected knee were collected and evaluated with both traditional microbial culture and polymerase chain reaction-electrospray ionization-time-of-flight mass spectrometry (molecular diagnostics [MDx]) to prospectively characterize the microbial content. Patients were grouped by diagnosis into one of two cohorts, those with clinical suspicion of septic arthritis (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200944) and those undergoing primary arthroplasty of the knee for OA (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200921). In all cases where discrepant culture and MDx results were obtained, we performed species-specific 16S rRNA fluorescence\n                    <jats:italic toggle=\"yes\">in situ<\/jats:italic>\n                    hybridization (FISH) as a confirmatory test.\n                    <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    MDx testing identified bacteria in 50% of the suspected septic arthritis cases and 29% of the arthroplasty cases, whereas culture detected bacteria in only 16% of the former and 0% of the latter group. The overall difference in detection rates for culture and MDx was very highly significant,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    -value\u2009=\u20092.384\u2009\u00d7\u200910\n                    <jats:sup>\u22127<\/jats:sup>\n                    . All of the culture-positive cases were typed as\n                    <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                    . Two of the septic arthritis cases were polymicrobial as was one of the OA cases by MDx. FISH testing of the specimens with discordant results supported the MDx findings in 91% (19\/21) of the cases, including one case where culture detected\n                    <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                    and MDx detected\n                    <jats:italic toggle=\"yes\">Streptococcus agalactiae.<\/jats:italic>\n                    <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    MDx were more sensitive than culture, as confirmed by FISH. FISH only identifies bacteria that are embedded or infiltrated within the tissue and is thus not susceptible to contamination. Not all suspected cases of septic arthritis contain bacteria, but a significant percent of patients with OA, and no signs of infection, have FISH-confirmed bacterial biofilms present in the knee.\n                  <\/jats:p>","DOI":"10.1089\/gtmb.2016.0080","type":"journal-article","created":{"date-parts":[[2016,10,17]],"date-time":"2016-10-17T14:04:13Z","timestamp":1476713053000},"page":"721-731","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Polymerase Chain Reaction-Electrospray-Time-of-Flight Mass Spectrometry Versus Culture for Bacterial Detection in Septic Arthritis and Osteoarthritis"],"prefix":"10.1177","volume":"20","author":[{"given":"Michael P.","family":"Palmer","sequence":"first","affiliation":[{"name":"Orthopedic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael","family":"Melton-Kreft","sequence":"additional","affiliation":[{"name":"Center of Excellence in Biofilm Research"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Nistico","sequence":"additional","affiliation":[{"name":"Center of Excellence in Biofilm Research"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. 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