Infective Arthritis: Bacterial 23S rRNA Gene Sequencing as a Supplementary Diagnostic Method

Claus Moser1, 2, Keld Andresen1, Anne Kjerulf1, 3, Suheil Salamon1, 4, Michael Kemp1, Jens Jørgen Christensen1, *
1 Department of Bacteriology, Mycology, and Parasitology, Statens Serum Institut, Copenhagen, and the Departments of Clinical Microbiology
2 Copenhagen University Hospital, Rigshos
3 Copenhagen University Hospital, Herlev
4 Vejle Sygehus, Denmark

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© Moser et al.; Licensee Bentham Open

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* Address correspondence to this author at the Department of Bacteriology, Mycology and Parasitology, Statens Serum Institut, 2300-Copenhagen, Denmark; Tel: +4532683572; E-mail:


Consecutively collected synovial fluids were examined for presence of bacterial DNA (a 700-bp fragment of the bacterial 23S rRNA gene) followed by DNA sequencing of amplicons, and by conventional bacteriological methods. One or more microorganisms were identified in 22 of the 227 synovial fluids (9,7%) originating from 17 patients. Sixteen of the patients had clinical signs of arthritis. For 11 patients molecular and conventional bacterial examinations were in agreement. Staphylococcus aureus, Streptococcus dysgalactiae subspecies equisimilis and Streptococcus pneumoniae, were detected in synovial fluids from 6, 2 and 2 patients, respectively. In 3 patients only 23S rRNA analysis was positive; 2 synovial fluids contained S. dysgalactiae subspecies equisimilis and 1 S. pneumoniae). The present study indicates a significant contribution by PCR with subsequent DNA sequencing of the 23S rRNA gene analysis in recognizing and identification of microorganisms from synovial fluids.

Key Words: Synovial fluid, 23S rRNA, PCR, bacteria, infective arthritis.