Real-life diagnostic performance and clinical impact of the BIOFIRE Joint Infection Panel in joint infections

OBJECTIVE: Rapid and accurate pathogen identification is critical for the effective management of native septic arthritis (NSA) and periprosthetic joint infections (PJIs), enabling timely, targeted antimicrobial therapy and improving patient outcomes. This study aimed to evaluate the diagnostic performance and clinical relevance of the BIOFIRE Joint Infection Panel (BJIP) in NSA and PJI. MATERIALS AND METHODS: A prospective investigation was conducted, including samples from patients with suspected NSA and PJI. The diagnostic performance and turnaround time of BJIP were compared to conventional culture methods, with an additional analysis of BJIP's clinical impact. RESULTS: A total of 80 patients were included. The BJIP displayed a higher sensitivity (67%) compared to conventional culture (47%), albeit without any statistical significance (p = 0.078), and a specificity of 94%. Total percent agreement was estimated at 66% ( = 0.36). The combination of BJIP and culture significantly improved sensitivity (74%) compared to conventional culture alone (p = 0.0001) or BJIP alone (p = 0.03). BJIP sensitivity was 57% in NSA and 72% in PJI, with a higher sensitivity observed in late acute PJI (90%) compared to early acute (60%) and chronic PJI (33%). However, this difference was not statistically significant (p = 0.122). Among patients with prior antibiotic therapy, BJIP exhibited significantly higher sensitivity than conventional culture (68% vs. 35%, p = 0.006). BJIP also reduced the turnaround time for pathogen detection by 83 hours. Retrospective analysis suggested a BJIP-based clinical management improvement among 31% of infected and 50% of uninfected individuals. CONCLUSIONS: Our study demonstrated a high sensitivity and specificity of BJIP in diagnosing joint infections. The combination of BJIP and conventional culture emerged as an optimal diagnostic approach. BJIP outperformed conventional culture among patients with prior antibiotic treatment, substantially reduced the turnaround time for pathogen identification, and showed potential for improving clinical management.

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