Application of ica D, eno, sar A and agr gene testing in early diagnosis of periprosthetic joint infection

Objective This study intends to explore the diagnostic efficiency and value of PCR in the early diagnosis of periprosthetic joint infection (PJI) based on the testing of the four staphylococcal specific genes ica D, eno, sar A and agr. Methods 41 samples of ultrasonic cleavage RNA eluate were extracted from the human joint model of PJI caused by the five most common PJI pathogens to detect the PCR of ica D, eno, sar A and agr genes. Based on the detection results, the sensitivity, specificity, positive and negative predictive value and accuracy of the four genes were analyzed and compared. Results eno test had a high sensitivity (83.33%). However, more false positive results affected the test specificity (47.06%); sar A test did not show false positive results, but the specificity was high (100%), but the sensitivity was low (41.67%); the sensitivity of ica D and agr test was 4.17% and 0%, respectively, and the clinical value was limited. Conclusion eno and sar A gene detection is of high value in early diagnosis of PJI. Reasonable design and sequential application of eno sensitivity preliminary diagnosis and sar A specific screening of false positive results are more beneficial to the early diagnosis of staphylococcal pathogenic PJI.