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The potential use of microcalorimetry in rapid differentiation between septic arthritis and other causes of arthritis

Yusuf, E. ; Hügle, T. ; Daikeler, T. ; Voide, C. ; Borens, O. ; Trampuz, A.

In: European Journal of Clinical Microbiology & Infectious Diseases, 2015, vol. 34, no. 3, p. 461-465

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    Titel
    • The potential use of microcalorimetry in rapid differentiation between septic arthritis and other causes of arthritis
    Autor
    • Yusuf, E.. Infectious Diseases Service, Department of Medicine, University Hospital, Lausanne, Switzerland
    • Hügle, T.. Division of Rheumatology, Department of Internal Medicine, University Hospital, Basel, Switzerland
    • Daikeler, T.. Division of Rheumatology, Department of Internal Medicine, University Hospital, Basel, Switzerland
    • Voide, C.. Infectious Diseases Service, Department of Medicine, University Hospital, Lausanne, Switzerland
    • Borens, O.. Orthopaedic Septic Surgical Unit, Department of Surgery and Anaesthesiology, University Hospital, Lausanne, Switzerland
    • Trampuz, A.. Infectious Diseases Service, Department of Medicine, University Hospital, Lausanne, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Journal of Clinical Microbiology & Infectious Diseases, 2015, vol. 34, no. 3, p. 461-465. Springer Berlin Heidelberg
    Andere elektronische Ausgabe
    Klassifikation
    • Gesundheit
    OAI-PMH-ID
    • oai:doc.rero.ch:331071
    Summary
    Current diagnostic methods in differentiating septic from non-septic arthritis are time-consuming (culture) or have limited sensitivity (Gram stain). Microcalorimetry is a novel method that can rapidly detect microorganisms by their heat production. We investigated the accuracy and time to detection of septic arthritis by using microcalorimetry. Patients older than 18years of age with acute arthritis of native joints were prospectively included. Synovial fluid was aspirated and investigated by Gram stain, culture and microcalorimetry. The diagnosis of septic arthritis and non-septic arthritis were made by experienced rheumatologists or orthopaedic surgeons. Septic arthritis was diagnosed by considering the finding of acute arthritis together with findings such as positive Gram stain or positive culture of synovial fluid or positive blood culture. The sensitivity and specificity for diagnosing septic arthritis and the time to positivity of microcalorimetry were determined. Of 90 patients (mean age 64years), nine had septic arthritis, of whom four (44%) had positive Gram stain, six (67%) positive synovial fluid culture and four (44%) had positive blood culture. The sensitivity of microcalorimetry was 89%, the specificity was 99% and the mean detection time was 5.0h (range, 2.2-8.0h). Microcalorimetry is an accurate and rapid method for the diagnosis of septic arthritis. It has potential to be used in clinical practice in diagnosing septic arthritis.