Serum markers, next-generation sequencing may diagnose infection in orthopedic surgery
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As difficulties exist in the diagnosis of infection in orthopedic surgery, researchers have turned their attention to serum markers, next-generation sequencing and phage therapy as possible diagnosis solutions, according to a presenter.
“In recent years [we], as well as other investigators, have been looking for some serum markers for diagnosis of infection,” Javad Parvizi, MD, FRCS, said in his presentation of the Gerard A. Engh, MD, Keynote Lecture at the Current Concepts in Joint Replacement Winter Meeting.
He added technologies that identify bacteria in the blood of patients with Lyme’s disease, endocarditis and meningitis have also been applied in orthopedics for identifying infection.
“Culture is beginning to fall out of favor as it is an old technology that fails to isolate organisms existing in the form of biofilm,” Parvizi said. “The role of polymerase chain reaction in the past has been explored with some issues and, in recent years, next-generation sequencing and metagenomics have been shown to have extremely promising results.”
When it comes to therapeutics, research has shown antimicrobial peptides may be effective in the prevention and eradication of biofilm and infection, according to Parvizi. He added lugdunin, an enzyme produced by Staphylococcus lugdunensis, may eradicate Staphylococcus aureus biofilm.
Finally, phage therapy, which involves the elimination of infections with the use of bacterial viruses, is being applied due to the rise in antimicrobial resistant organisms, Parvizi said.
“I am hopeful that technologies like phage and others that rely on antimicrobial techniques other than antibiotics will have a great role in the future for eradication of infection in our patients,” Parvizi said. “We need to rely on other technologies in the future, as what we have so far, does not seem to work and our patients continue to suffer.”
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Parvizi J. What is next in infection: Molecular testing? Antibiotic coatings? Phage therapy? Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 8-12, 2020 (virtual meeting).
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