Comparative Study of Two Molecular Methods and Culture for the Detection of Microbial Agents in Patients with Osteomyelitis and Septic Arthritis

Abdollahi, Hossein; Emami Meybodi, Mohammad Kazem; Shirvani Boroujeni, Shahram; Izadi, Morteza; Hosseini, Morteza; Mohammadnabi, Sajjad

doi:10.22034/ijos.2025.546299.1153

Comparative Study of Two Molecular Methods and Culture for the Detection of Microbial Agents in Patients with Osteomyelitis and Septic Arthritis

Document Type : Original Article

Authors

Hossein Abdollahi ¹

Mohammad Kazem Emami Meybodi ¹

Shahram Shirvani Boroujeni ¹

Morteza Izadi ¹

Morteza Hosseini ¹

sajjad mohammadnabi ²

¹ Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

² Baqiyatallah University of Medical Sciences

https://doi.org/10.22034/ijos.2025.546299.1153

Abstract

Introduction: Infection is a major orthopedic concern, particularly following knee replacement. Postoperative infection poses significant risks, and in trauma patients with open wounds, it can lead to severe complications. Managing these infections often requires prolonged antibiotic therapy, extended hospitalization, and, in many cases, revision surgery for joint replacement or repeated debridement in osteomyelitis—resulting in serious patient morbidity. Given the high rate of self-administered antibiotics and negative culture tests in joint infections, this study compares molecular (PCR) and culture methods for detecting microbial agents in osteomyelitis and septic arthritis.
Materials & Methods: In this cross-sectional study, 100 samples from patients with joint infections and osteomyelitis at a Hospital were analyzed using microbial culture and PCR. Demographic data (age, gender), comorbidities, and clinical signs (fever, chills, swelling, discharge, pain, limited mobility) were extracted from medical records. Data were analyzed using SPSS22.
Results & Discussion: Among 100 samples, 80 tested positive via PCR, while 55 were culture-positive. Conversely, 20% were PCR-negative and 45% culture-negative. A statistically significant difference existed between the two methods in detection rates (P < 0.04).
The patient factors such as old age, previous medical conditions, high BMI, osteopenia, and intraoperative factors, including failure to correct lumbar lordosis, sagittal balance, and correction of angles in primary surgery, showed increased risk for revision spine surgery.
Conclusion: PCR is faster and more accurate than culture for diagnosing osteomyelitis and septic arthritis, enabling earlier treatment intervention.

Keywords

Polymerase chain reaction, Cell culture, Osteomyelitis, Infectious arthritis

Subjects