An orthopedic infection that is not related to a prosthetic joint infection (PJI) is an infection that can affect the bones (osteomyelitis) and joints (septic arthritis). These infections can result from trauma such as an open fracture or a crush injury but can also occur after surgery. There are several ways in which you can become infected, including via germs (organisms) that are carried in the blood and surgical procedures that are not perfectly sterile.
Chronic infections resulting from orthopedic surgery are a major challenge both for surgeons and patients. Bacteria are the most common cause of infection although fungi and viruses can also be responsible. These microorganisms can be difficult to treat because they are resistant to antibiotics and antifungal medicine. In addition, bacteria can group together to form a layer of biofilm, which requires a greater concentration of antibiotics to treat.
An orthopedic infection can be acute or chronic. Acute infections usually happen 48 to 72 hours after surgery or trauma. In chronic cases, there might be a dead piece of bone.
Diseases like diabetes that affect blood circulation to bones can increase the likelihood of orthopedic infections. Smoking is a significant risk factor as well.
Symptoms of an Orthopedic Infection
Acute infections are usually accompanied by localized pain, swelling, and reddening of the skin. Symptoms of a chronic infection can include drainage, weakened muscles, and less range of motion. If you have had the infection for a long time, you might also feel tired.
MicroGenDX Test Used in Diagnosing Orthopedic Infections
If you have an orthopedic infection, you will need a laboratory test that your doctor can order to determine the cause of the infection.
An evaluation and culture (growing microbes from your sample in a lab) are often used to diagnose infections. However, standard cultures might come back negative even when you actually do have an infection, and that means your infection won’t be treated. Instead of relying on culture, a MicroGenDX test detects the DNA of all microbes in your sample along with how much of each microbe is present. MicroGenDX then uses that information to determine the drugs that can best treat the infection.
You can order the MicroGenDX SurgeryKEY test and get complete instructions here: https://microgendx.com/product/surgerykey-test-service/
Providing a Sample for the Orthopedic Infection Test
Getting a good sample is important in the diagnosis of bone and joint infections. To collect a sample, your doctor will use one or all of these methods:
- Sterile Swabs
- CaptiGen Flatswabs
Your doctor will roll the swab over the entire surface of the infected area, applying pressure as the swab moves across the infection. As much material as possible needs to be gathered on the swab to ensure a conclusive sample. Then the swab will be inserted into the specimen tube, which will be sealed tightly.
Everything you need to know about how samples for the SurgeryKEY test are taken is included with the SurgeryKEY test and is also available online on the product page. The instructions included with your test contain illustrations that will help you to help your doctor collect a sample without contaminating it. It is always important to obtain a proper sample by following the instructions for collecting the sample, as well as when packaging and shipping it. For example, with either method, be sure not to contaminate the sample by touching it with your hands. For best results, you must be off all antibiotics for two days before the sample is collected (a condition that only your physicians should discuss with you). However, if this is not possible, the test can still be performed.
Medical Specialties Treating Orthopedic Infections
A primary care physician is the first contact for treatment; an orthopedic surgeon should be consulted for advanced care.
How Orthopedic Infections Are Treated
Accurate diagnosis of the orthopedic infection is important to determine the best treatment method. Traditional culture-based as well as molecular methods are used to detect pathogens.
It is important to know which microbes are present in wounds that won’t heal; qPCR+NGS testing allows you to do exactly that. Molecular testing is 20 times more precise than other methods when identifying microbe species, so your doctor can select the appropriate antimicrobial treatment options.
It is important to know that not all antibiotics work for all bacteria, and some even work differently in different areas of the body. MicroGenDX offers "antimicrobials for consideration" chart on your MicroGenDX report to assist your physician regarding treatment options.
It is important to complete the full course of medication as it is prescribed, even when symptoms begin to clear up before you are treated. All MicroGenDX diagnostic tests include detection of antibiotic resistance genes in your sample and provide alternative antibiotics for your doctor to consider prescribing to you.
- Winkler H. Treatment of chronic orthopaedic infection. EFORT Open Rev. 2017 May 11;2(5):110-116. doi: 10.1302/2058-5241.2.160063. PMID: 28630748; PMCID: PMC5467682.