Demonstration of Bacillus cereus in Orthopaedic-Implant-Related Infection with Use of a Multi-Primer Polymerase Chain Reaction-Mass Spectrometric Assay

The recent advent of a novel coupled PCR-mass spectrometric technology, the Ibis T5000(Abbott Laboratories, Chicago, Illinois) offers multiple potential advantages for molecular detection of periprosthetic joint infection or other implant-related infections. The Ibis assay simultaneously tests for >3,000 species, including virtually all known pathogens, in a multiplex fashion, eliminating the need for an a priori choice regarding the likely infecting organism. For known pathogens, the Ibis is capable of yielding information down to the species level and can simultaneously assay for antibiotic resistance markers. It is semiquantitative and provides for a rapid turnaround, with clinically useful results available in as little as six hours. Although the Ibis T5000 is not yet approved by the Food and Drug Administration (FDA) for use in clinical diagnostics, we have used it to investigate clinical samples from multiple sources.