P-C-R you sure it’s more helpful in joint infections?

Reviewed by Jen Cihlar, DO, Vanderbilt University Medical Center

A retrospective study compared the Biofire joint infection assay (BJA) comprised of 31 bacterial and fungal pathogens to the standard of care culture-based diagnostics (SOC) in 120 synovial fluid samples. The BJA correctly identified all “on-panel” pathogens recovered in SOC (9/15) but only identified 4 additional pathogens in the negative SOC cases, while the other 6 (40%) recovered in SOC were “off-panel” organisms not detected by BJA. Using the BJA did have the benefit of quicker turnaround time to yield an organism (49 h vs 99 h) especially in the 4 culture negative SOC cases to assist in antibiotic de-escalation. However, the authors noted that the BJA may be more useful in native joint infections vs prosthetic joint infections as the BJA does not include targets for clinically relevant pathogens (e.g. Cutibacterium acnes, coagulase negative Staphylococci).

Berinson B, Spenke L, Krivec L, et al. Performance and Hypothetical Impact on Joint Infection Management of the BioFire Joint Infection Panel: a Retrospective Analysis [published online ahead of print, 2023 Jul 13]. J Clin Microbiol. 2023;e0059223. doi:10.1128/jcm.00592-23

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