Real-time Pcr without Dna Extraction: a Modification for More Rapid Detection of Bacteria on Orthopaedic Implants

Introduction Infection is one of the most important causes of joint implant failure. The polymerase chain reaction (PCR) is a sensitive way to test for bacteria, but most PCR procedures take too long to provide results during a revision arthroplasty operation. For example, we have described the sensitivity and specificity of real-time PCR combined with ultrasonication of retrieved implants to detect trace levels of bacteria within about 4 hours from the time of implant removal. It would be desirable to have the results of PCR testing available more rapidly. Most PCR techniques require time-consuming extraction of DNA from the sample, but several studies have suggested that ultrasonication alone may yield adequate DNA for PCR analysis. The purpose of this study was to evaluate reducing the time required for PCR by ultrasonication without subsequent DNA extraction using an in vitro implant infection model.