Performance and potential utility of the BioFire Joint Infection Panel with synovial fluid and joint tissue...

Area of Science:

• Microbiology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Joint infections require timely and accurate diagnosis for effective treatment.
• Traditional culture-based methods can be slow, delaying appropriate patient management.
• Multiplex polymerase chain reaction (PCR) platforms offer potential for rapid pathogen identification.

Purpose of the Study:

• To evaluate the performance of the BioFire Joint Infection Panel (BJIP) in diagnosing joint infections.
• To compare BJIP results with standard laboratory testing using synovial fluid and joint tissue specimens.
• To assess BJIP performance in native versus prosthetic joints.

Main Methods:

• Retrospective analysis of 224 synovial fluid and joint tissue specimens from 134 patients.
• Comparison of BJIP results against a composite standard of care (culture, 16S rRNA gene PCR/sequencing).
• Subgroup analysis for native and prosthetic joints, and specimen types.

Main Results:

• The BJIP demonstrated high positive percent agreement (PPA) for common on-panel organisms (e.g., Staphylococcus aureus, Streptococcus spp.).
• No significant difference in PPA was observed between synovial fluid and joint tissue, or native and prosthetic joints.
• Overall PPA was reduced by the absence of specific pathogens like Cutibacterium acnes in prosthetic joint infections.

Conclusions:

• The BJIP is a reliable tool for detecting common pathogens in both synovial fluid and joint tissue.
• While effective, the panel's performance is impacted by the omission of certain key pathogens in prosthetic joint infections.
• Implementing the BJIP upfront can expedite diagnosis and potentially optimize patient care for joint infections.