The Role of BioFire Joint Infection Panel in Diagnosing Periprosthetic Hip and Knee Joint Infections in Patients with Unclear Conventional Microbiological Results

Overview

Journal Bone Joint Res

Date 2024 Jul 9

PMID 38981611

Authors

Susana Gardete-Hartmann

Jennyfer A Mitterer

Sujeesh Sebastian

Bernhard J H Frank

Sebastian Simon

Stephanie Huber

Marcellino Low

Ian Sommer

Morjan Prinz

Milo Halabi

Jochen G Hofstaetter

Affiliations

Soon will be listed here.

Abstract

Aims: This study aimed to evaluate the BioFire Joint Infection (JI) Panel in cases of hip and knee periprosthetic joint infection (PJI) where conventional microbiology is unclear, and to assess its role as a complementary intraoperative diagnostic tool.

Methods: Five groups representing common microbiological scenarios in hip and knee revision arthroplasty were selected from our arthroplasty registry, prospectively maintained PJI databases, and biobank: 1) unexpected-negative cultures (UNCs), 2) unexpected-positive cultures (UPCs), 3) single-positive intraoperative cultures (SPCs), and 4) clearly septic and 5) aseptic cases. In total, 268 archived synovial fluid samples from 195 patients who underwent acute/chronic revision total hip or knee arthroplasty were included. Cases were classified according to the International Consensus Meeting 2018 criteria. JI panel evaluation of synovial fluid was performed, and the results were compared with cultures.

Results: The JI panel detected microorganisms in 7/48 (14.5%) and 15/67 (22.4%) cases related to UNCs and SPCs, respectively, but not in cases of UPCs. The correlation between JI panel detection and infection classification criteria for early/late acute and chronic PJI was 46.6%, 73%, and 40%, respectively. Overall, the JI panel identified 12.6% additional microorganisms and three new species. The JI panel pathogen identification showed a sensitivity and specificity of 41.4% (95% confidence interval (CI) 33.7 to 49.5) and 91.1% (95% CI 84.7 to 94.9), respectively. In total, 19/195 (9.7%) could have been managed differently and more accurately upon JI panel evaluation.

Conclusion: Despite its microbial limitation, JI panel demonstrated clinical usefulness by complementing the traditional methods based on multiple cultures, particularly in PJI with unclear microbiological results.

Citing Articles

Clinical performance evaluation of the BioFire Joint Infection Panel.

Lee R J Clin Microbiol. 2024; 62(11):e0102224.

PMID: 39382308 PMC: 11559011. DOI: 10.1128/jcm.01022-24.

Diagnosis and Treatment of Acute Periprosthetic Infections with the BioFire System within a Time-Dependent and Bacterium-Dependent Protocol: Review and Prosthesis-Saving Protocol.

Sangaletti R, Andriollo L, Montagna A, Franzoni S, Colombini P, Perticarini L Biomedicines. 2024; 12(9).

PMID: 39335595 PMC: 11428812. DOI: 10.3390/biomedicines12092082.

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