Application of Molecular Diagnostics in Periprosthetic Joint Infection Microorganism Identification Following Screening Colonoscopy: A Case Report and Review of the Literature

Background: Culture-negative periprosthetic joint infections (PJIs) are dramatically increasing in prevalence. The success rate of implant-saving procedures in acute PJI cases is closely correlated with prompt diagnosis, rapid isolation/identification of the microorganism, and timely surgical intervention. Methods: A 70-year-old female patient with an acutely infected left total hip arthroplasty (THA) following a routine screening colonoscopy was rapidly treated with debridement, antibiotic pearls, and retention of the implant (DAPRI) after rapid identification of the microorganism using a molecular diagnostics-based algorithm. Results: Molecular diagnostics enabled the identification of Escherichia coli as the causative agent of the transient bacteremia and subsequent seeding of the left hip within less than an hour. Conclusions: This case suggests that endoscopic procedures may increase the risk to joint replacement patients. In acute PJI, the use of molecular diagnostics, which facilitates prompt identification of microorganisms, may increase the success rate of implant-saving surgical procedures.