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Published on: October 23, 2011
Evaluation of a BioFire multiplex PCR panel for detection of joint infections using retrospective and prospectively
Angelica Moran1,2, Jekzaly Arellano1, Karen Bregman1
1Department of Pathology and Laboratory Medicine, Endeavor Health, Evanston, Illinois, USA.
Abstract:
The BioFire Joint Infection Panel (JI panel) is a newly FDA-approved multiplex PCR assay for detection of common bone and joint pathogens with 39 targets which include select Gram-positive and Gram-negative bacteria, yeast, and antimicrobial resistance genes. We evaluated the performance of the JI panel in detecting joint infections in our patient population. Sixty-three frozen, residual joint fluid specimens were retrospectively tested using the JI panel. An additional 104 residual joint fluid specimens were de-identified and prospectively tested within 1 week of collection. Results from routine bacterial cultures were used as the reference standard, which included inoculation to agar plates and blood culture bottles. For the frozen specimens, the JI panel showed a positive percent agreement (PPA) of 92.8% and a negative percent agreement (NPA) of 97.1%. PPA was 71.4% and NPA was 94.8% for fresh specimens. A total of 12 discrepancies were observed among the 167 specimens tested. The JI panel demonstrated good overall agreement with routine culture for the detection of joint infections and may improve timely diagnosis when used in conjunction with bacterial culture. However, potential false-positive and false-negative results were observed in both retrospective and prospective testing of specimens.IMPORTANCEThe BioFire JI panel is a new commercially available multiplex PCR assay for detecting common pathogens causing bone and joint infections. The test is performed directly on joint fluids with a fast turnaround time of 1 hour. Our study shows that while the JI panel overall shows good agreement with routine culture, discrepancies were observed in 7% of cases and results should be interpreted with appropriate clinical context.
Insights
The new BioFire Joint Infection (JI) panel accurately detects bone and joint infection pathogens. While showing good agreement with standard cultures, potential false results necessitate clinical context for accurate diagnosis.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Bone and joint infections require rapid and accurate pathogen identification for effective treatment.
- Traditional culture methods can be time-consuming, delaying diagnosis and therapeutic intervention.
- Multiplex PCR assays offer a faster alternative for detecting a broad range of pathogens.
Purpose of the Study:
- To evaluate the performance of the FDA-approved BioFire Joint Infection (JI) panel for detecting pathogens in joint fluid specimens.
- To compare the JI panel's results against standard bacterial culture methods.
- To assess the diagnostic utility of the JI panel in a clinical setting.
Main Methods:
- Retrospective testing of 63 frozen and prospective testing of 104 fresh residual joint fluid specimens using the BioFire JI panel.
- Comparison of JI panel results with results from routine bacterial cultures (agar plates and blood cultures).
- Calculation of positive percent agreement (PPA) and negative percent agreement (NPA) for both specimen types.
Main Results:
- The JI panel demonstrated high PPA (92.8%) and NPA (97.1%) for frozen specimens.
- For fresh specimens, PPA was 71.4% and NPA was 94.8%.
- A total of 12 discrepancies (approximately 7%) were observed across 167 specimens tested.
Conclusions:
- The BioFire JI panel shows good overall agreement with routine bacterial culture for diagnosing joint infections.
- The panel has the potential to expedite diagnosis due to its rapid turnaround time.
- Discrepancies highlight the importance of interpreting JI panel results within the appropriate clinical context to avoid potential false positives or negatives.
