The detection of DNA from a range of bacterial species in the joints of patients with a variety of arthritides using a nested, broad-range polymerasechain reaction

Objective. Bacteria have been implicated in the pathogenesis of many types of inflammatory arthritides. The aim of this study was to identify any bact erial DNA. in synovial fluid (SF) from patients with a range of inflammator y arthritides. Methods. A highly sensitive, broad-range, nested polymerase chain reaction (PCR) protocol targeting the bacterial 16S rRNA gene was designed and appli ed to SF from 65 patients with a range of rheumatic diseases. Results. Bacterial DNA was detected in 26 SF samples, including eight from patients with rheumatoid arthritis and five with juvenile arthritides. PCR products were identified by sequencing and searching of bacterial genomic d atabases; 'best fits' included Haemophilus influenzae, Bordetella and Yersi nia. Conclusions. These finding suggest an association between bacterial infecti on and inflammatory arthritides in some patients. Further research is requi red to determine the role of these organisms in the pathogenesis and whethe r such patients might respond to prolonged antibiotic therapy.