J Bone Jt Infect 2019; 4(5):227-233. doi:10.7150/jbji.36015

Research Paper

Multiplex Antibody Measurement for Post-treatment Follow-up of Staphylococcal Prosthetic Joint Infection: A Diagnostic Pilot Study

Thomas BAUER1*, Simon MARMOR2*, Idir GHOUT3, Elsa SALOMON4,5, Faten EL SAYED4,5, Beate HEYM6, Martin ROTTMAN5,7, Jean-Louis GAILLARD4,5, Anne-Laure ROUX4,5✉

1. Service de Chirurgie Orthopédique et Traumatologie, Hôpital Ambroise Paré (Assistance Publique - Hôpitaux de Paris, AP-HP), Boulogne-Billancourt, France.
2. Centre de référence des infections ostéo-articulaires, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France.
3. Unité de Recherche Clinique Paris Île-de-France Ouest, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France.
4. Laboratoire de Microbiologie, Hôpital Ambroise Paré (AP-HP), Boulogne-Billancourt, France.
5. UMR 1173, UFR Simone Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.
6. Service de Microbiologie, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France.
7. Laboratoire de Microbiologie, Hôpital Raymond Poincaré (AP-HP), Garches, France.
* Equal contribution.

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Citation:
BAUER T, MARMOR S, GHOUT I, SALOMON E, SAYED FE, HEYM B, ROTTMAN M, GAILLARD JL, ROUX AL. Multiplex Antibody Measurement for Post-treatment Follow-up of Staphylococcal Prosthetic Joint Infection: A Diagnostic Pilot Study. J Bone Jt Infect 2019; 4(5):227-233. doi:10.7150/jbji.36015. Available from http://www.jbji.net/v04p0227.htm

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Abstract

Introduction: Multiplex-antibody detection has been recently proposed for the noninvasive diagnosis of staphylococcal prosthetic joint infection (PJI). We evaluated this approach for the post-treatment follow-up of patients.

Methods: Nineteen cases of staphylococcal PJI were prospectively followed for one year after treatment. The IgG response against eight staphylococcal antigens was measured before surgery and one year post-surgery using Luminex technology (Austin, TX, USA); median fluorescence intensity values determined for each antigen were transformed into a “Total Response Index” (TRI).

Results: Patients (11 women/8 men) had a mean (SD) age of 72.2 (12.4) years. Site of prosthesis was the knee (n=10), the hip (n=8) and the shoulder (n=1). Ten patients were infected by S. epidermidis, six by S. aureus, and three by S. lugdunensis. TRI values at one year were significantly lower than pre-surgery values (mean [SD]: 5.9 [1.8] versus 8.1 [3.4], p=0.02) and decreased, on average, by 21.2%. TRI values markedly increased in two patients. One patient had a relapse of S. aureus PJI at five months post-surgery, with a 37% increase of the TRI. The other had septic failure three months after revision for S. lugdunensis PJI; all intraoperative samples remained culture-negative, but the TRI increased by 51% and the antibody profile showed a marked change, suggesting a reinfection with another staphylococcal species.

Conclusion: Multiplex-antibody measurement may be useful for the follow-up of staphylococcal PJI and may help to detect septic failure involving organisms targeted by the assay.

Keywords: prosthetic joint infection, follow-up, multiplex antibody detection, biomar