Novel diagnostic method will improve the precision of capturing infections during surgery

Head of the Molecular Laboratory at the UP Faculty of Medicine and Dentistry Department of Immunology, Eva Kriegová.
wednesday 22. november 2017, 8:36 – Text: Velena Mazochová

Determining infections in the vicinity of prostheses during an operation has been made possible by a new diagnostic method which was developed by experts from the Departments of Orthopedics and Immunology at UP in cooperation with the Department of Cybernetics and Biomedical Engineering at the Technical University of Ostrava. The novel procedure, which at present refines and speeds up the diagnosis of infection in joint replacements, was announced in one of the world’s leading professional journals, the Journal of Clinical Microbiology.

Infections remain one of the main complications which threaten the outcome of implantation of joint replacements. Their presence also influences the choice of the specific surgical procedure. The new method should help orthopedists’ decisions in the operating room – not only due to its accuracy, but also due to the speed in which surgeons get the necessary information. “The entire diagnostic procedure takes about forty minutes from taking the tissue to getting the result. The surgeon thus gets quick, quality information on how high the probability is that there is infection. The immunological method is based on a special decision-making algorithm, and the resulting information is in a form which facilitates the decision. If the joint is infected, then the patient must undergo a different method than with a ‘clean’ operation," explained the head of the Department of Orthopedics, Jiří Gallo.

The principle of the new method, used primarily in reoperations on total endoprostheses, arose thanks to the successful linking of immunology and orthopedics with specialised bioinformatic methods for analysing large sets of molecular biologic data. “Tissue reacts to the presence of pathogenic microorganisms by producing antimicrobial proteins and other signal molecules which we are capable of identifying via gene profiling. The novel procedure, which is able to detect an ‘infection profile’ from individual gene profiles and large amounts of data and incorporate it into a decision-making algorithm, was developed by our colleagues at Ostrava Technical University,“ explained Eva Kriegová, head of the molecular laboratory at the Department of Immunology.

In creating the application, the research team made use of the fastest model of a machine for polymerase chain reactions – a thermocycler. "To be specific, it is an Xxpress thermocycler, which allows such fast amplification, i.e. magnifying the DNA segment, that we can get the result just minutes after collecting the tissue,” added Regina Fillerová, the lead author of the article.

“From the point of view of the clinic, I appreciate the combination of speed in giving results and its specificity in relation to the infected inflammation. We use antibacterial molecules in clinical practice – this is a test for alpha-defensin. Nevertheless, the approach which the immunologists and computer scientists have offered us is different in that it looks at a more complicated picture, because it works with a group of molecules, rather than just one. The result which we get appears more complex and realistic. The forty minutes allow the surgeon to change operation techniques in case the result is positive for infection. However, we still need to carry out clinical studies in order to prove the value of the new test in practice,” said Jiří Gallo.

Cooperation between the UP Departments of Immunology and Orthopedics and the Department of Electrical Science and Computer Science at Ostrava Technical University is ongoing successfully within the auspices of the project OLGEN, started in 2015. Its goal is the development of biomedicine and approaches making possible preparation of treatments “made to order” for patients through making use of the most modern innovative technologies. Their current scientific research activities are directed at the importance of immune differences and changes in diseases of the motor system, in rheumatic and lung diseases, and in hemato-oncological diseases.